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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.
cough and chills.
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a right-sided catheter is present. it probably overlies the mid/ distal svc. no pneumothorax is detected. there is probable background hyperinflation/copd. there is probable mild cardiomegaly. the mediastinum is slightly prominent, with convexity in the ap window, consistent with known mediastinal lymphadenopathy. the hila are not obviously enlarged. there are increased interstitial markings diffusely, with peribronchial cuffing and thickening of the minor fissure. there is only slight upper zone redistribution. a lateral view shows very small posterior pleural effusions. there are patchy bibasilar opacities more pronounced on the left.
<unk> year old man with hyperviscosity syndrome who has increased sob // <unk> year old man with hyperviscosity syndrome who has increased sob
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pa and lateral views of the chest are compared to previous exam from <unk>. the lungs are hyperinflated but remain clear of confluent consolidation or pleural effusion. suprahilar nodular opacity in the right is again seen and unchanged. cardiac silhouette is within normal limits. osseous structures again notable for old, healed left lateral rib fractures.
<unk>-year-old male with shortness of breath, cough, history of copd. lung sounds with crackles and rhonchi.
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the heart size and mediastinal contours are within normal limits. the lungs are clear of consolidations, cavitary masses or abnormal calcifications. there is no pleural effusion. the visualized portion of the spine appears normal.
<unk>-year-old female with positive ppd, but negative quantiferon test.
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there is no focal lung consolidation. cardiomediastinal silhouette is within normal limits. there is mild tortuosity of the thoracic aorta. there is no overt pulmonary edema. there is no free subdiaphragmatic gas.
<unk>f with abd pain, new qa the inversion on ekg, evaluate for pneumonia..
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new esophageal ube loops and ends within the thorax, likely within a large hiatal hernia. otherwise there is no significant change compared with the previous exam. the endotracheal tube ends <num> cm above the carina. a right sided ij line ends in the upper to mid svc. a right-sided picc ends in the lower svc. there is no evidence of pneumothorax. no focal opacities concerning for pneumonia identified. no pleural effusion is identified. previous right costophrenic angle vague opacity has cleared and it was most likely due to positioning. there is no pneumothorax. cardiomediastinal and hilar contours are unremarkable.
<unk>-year-old female with new esophageal tube placement.
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lungs are clear. cardiomediastinal silhouette and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.
<unk>-year-old man with chest pain, question pneumonia.
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in comparison to prior exam, there is improved inspiratory effort and improved lung volumes. allowing for changes due to this, the cardiomediastinal silhouettes are stable, possibly with mild cardiomegaly. a right-sided picc line terminates at the mid to low svc. the bilateral hila are unremarkable. retrocardiac opacity likely represents basilar atelectasis. the lungs are otherwise clear. there is no evidence of pulmonary vascular congestion. there is a persistent small right pleural effusion. there is no left pleural effusion or pneumothorax.
<unk> year -old man with fevers and cough, evaluate for pneumonia.
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single portable ap radiograph was provided. et tube is present with the tip below the clavicles. the carina is not definitely seen. ng tube is seen coursing below the diaphragm. there is no pneumothorax. opacities at the bases may represent atelectasis; however, infection cannot be excluded. there may be a small left pleural effusion. osseous structures are intact.
<unk>-year-old male intubated.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. multiple right-sided rib fractures including the posterior right fifth through eighth ribs are seen which may be subacute.
history: <unk>m s/p fall on mountain bike, found to have bl ue fractures, fell onto head, not wearing helmet // ue plain films- r/o fracturect head- r/o sdhct neck- r/o fracture
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postoperative changes including: median sternotomy wires, vascular postoperative clips and mild scarring overlying the anterior heart (on the lateral). there are no pulmonary consolidations, pneumothorax or pleural effusions. there are no pleural effusions. the aorta is markedly ectatic. on the lateral, a bochdalek hernia is seen, confirmed on ct.
<unk> year old man with copd and worse doe for a few months // assess for any chf, effusions, ild, etc assess for any chf, effusions, ild, etc
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the heart, mediastinum, hila, and pleural surfaces are normal. lungs are clear without pleural effusion or consolidation.
<unk> year old woman with gi bleed and new hypoxemia. please eval for e/o aspiration vs pneumonia.
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heart size is normal. dense atherosclerotic calcifications are noted within the aorta. the mediastinal and hilar contours are within normal limits. previous pattern of mild pulmonary vascular congestion has improved. lungs are hyperinflated. no focal consolidation, pleural effusion or pneumothorax is seen. chronic appearing right posterior seventh rib fracture is present.
history: <unk>f with left hip fracture, concern for hypertensive urgency with pulmonary vascular congestion at outside hospital
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the patient is rotated somewhat to the right. no focal consolidation, pleural effusion, or evidence of pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. no overt pulmonary edema is seen.
history: <unk>f with cough of two weeks // pna?
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there is chronic atelectasis or scarring in the right middle lobe. the lungs are otherwise clear. minimal cardiomegaly is unchanged. there is no pneumothorax. there is no pleural effusion. pulmonary vascularity is normal.
<unk>-year-old man with cough and chest pain.
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frontal and lateral chest radiographs were obtained. the lungs are fully expanded and clear. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. there is no pleural effusion or pneumothorax.
patient with persistent hoarseness and history of smoking, evaluate etiology of hoarseness.
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pa and lateral views of the chest were reviewed and compared to the prior study. the lungs are clear. the heart size is normal and there is no evidence of vascular congestion, pleural effusion or pneumothorax. no concerning osseous or soft tissue lesions.
evaluation for pneumonia in a patient with fevers.
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since the prior exam the large left pleural effusion has significantly improved although a small amount of residual fluid and pleural thickening remain. areas of atelectasis are noted at the left lung base. the right lung is clear. cardiomediastinal silhouette is normal. there is no pneumothorax. right upper extremity picc terminates at the mid svc.
<unk> year old man s/p l vats decortication. evaluate for interval change
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blunting of the lateral and posterior costophrenic angles suggest small persistent bilateral effusions as seen on recent ct. the lungs are clear without focal consolidation edema or pneumothorax. cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities identified
<unk>m with weakness/cough // weakness/cough
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portable single ap chest radiograph was obtained with patient in upright position. there has been interval removal of the right chest tube with development of a small right apical pneumothorax. there is no mediastinal shift. at the left lung base opacity is unchanged, likely related to atelectasis. no pleural effusion or pulmonary edema is seen. cardiomediastinal contour is within normal limits.
status post mitral valve replacement, chest tube removal, eval for pneumothorax.
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single frontal view of the chest. there has been no substantial interval re-expansion of the collapsed right lung. right sided pneumothorax and large right pleural effusion are similar to prior. the left lung is clear. the right heart border is obscured but the left heart border and mediastinal contours are stable.
status post right lower lobe lobectomy with recurrent right lung collapse now status post bronchoscopy with re-expansion and recollapse.
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moderate enlargement of the cardiac silhouette is new compared to the previous exam. the aorta is mildly tortuous. hilar contours are normal. pulmonary vasculature is not engorged. retrocardiac opacity may reflect atelectasis, but infection is not excluded in the correct clinical setting. no pleural effusion or pneumothorax is present. degenerative changes are noted involving the left glenohumeral joint.
history: <unk>m with reported history of pneumonia presenting with fever, afib with rapid ventricular rate// please eval for pneumonia
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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.
<unk>m with chest pain // ?pneumonia
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linear right basilar opacities and hazy opacity at the right lung base correlate with chronic changes on prior ct scan. elsewhere, the lungs are grossly clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormality is identified. surgical clips project over the upper abdomen.
<unk>m with fevers // infiltrate?
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ap upright and lateral views of the chest provided. lungs are grossly clear. no convincing evidence for pneumonia or chf. no large effusion or pneumothorax. the cardiomediastinal silhouette appears grossly within normal limits. no free air below the right hemidiaphragm. <num> anchors are noted overlying the right humeral head. there is significant high riding of the right humeral head indicative of chronic rotator cuff disease. findings are less pronounced though also present on the left with associated left ac joint arthropathy.
<unk>m with chills // eval for pna
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the lungs remain hyperinflated.the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. degenerative changes are seen along the spine.
history: <unk>m with cp // infiltrate?
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a single frontal upright view of the chest was obtained portably. heterogeneous opacity at the right lung base may represent pneumonia or aspiration. there is no pleural effusion or pneumothorax. pulmonary vasculature is engorged and the azygous vein is larger. the cardiac silhouette is larger than on the prior study. mediastinal silhouette and hilar contours are normal. there is no free air under the diaphragm.
syncope and hypotension.
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there is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. the cardiomediastinal silhouette is unchanged.
<unk>f with +<unk>'s sign, evaluate for acute process.
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the cardiac mediastinal silhouettes within normal limits. asymmetric breast shadows. on the lateral view, there is slight blunting of the posterior costophrenic angle, which may be atelectasis or trace pleural effusion. however, there is not a gross consolidative process. slightly heterogeneous appearance of osseous structures may relate to the stated history of multiple myeloma.
multiple myeloma and fevers. evaluate for infection.
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pa and lateral chest radiographs were obtained. the lungs are well inflated and clear. no consolidation, nodule, effusion, or pneumothorax is present. the heart and mediastinal contour are normal. a left-sided port-a-cath enters the left ij and terminates in the mid svc. position is unchanged from <unk>.
<unk>-year-old woman with cord along left side of neck, catheter placed <unk>. evaluate for cvl port-a-cath placement.
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cardiac silhouette size is top normal. the aorta remains tortuous. mediastinal and hilar contours are unchanged. pulmonary vasculature is not engorged. patchy opacities in the lung bases may reflect atelectasis though infection or aspiration is not excluded in the correct clinical setting. no pleural effusion or pneumothorax is seen. there are mild degenerative changes noted in the thoracic spine.
history: <unk>m with weakness
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lungs are severely hypoinflated with bibasilar atelectasis. pulmonary vasculature and cardiac contour is accentuated as a result. no obvious parenchymal consolidation is seen.
history: <unk>m with abdominal pain and hyperglycemia. evaluate for infection.
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the swan-ganz catheter tip is seen slightly more advanced in the main pulmonary artery but still in the borders of the mediastinum. the lungs are clear. the left pacemaker is unchanged. heart size is moderately enlarged. no pneumothorax or pulmonary edema.
<unk> year old man with swan in place // <unk>
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frontal lateral views of the chest demonstrate left pectoral cardiac pacer with leads terminating in the right atrium and right ventricle. there is evidence of prior cabg. median sternotomy wires are intact. massive cardiomegaly is similar as before. low lung volumes are unchanged. there is interval improvement of previously mild interstitial edema. streaky retrocardiac opacities may be a combination of a chronic changes and subsegmental atelectasis. there is likely a small left pleural effusion.
<unk>-year-old female with chronic lung disease and baseline <num>l oxygen requirement presents with acute co<num> retention. question acute process.
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pa and lateral views of the chest. there has been interval progression of the right basilar consolidation which now completely silhouettes the hemidiaphragm. this is likely due to a combination of pleural effusion with underlying consolidation in the right lower and middle lobes. the left lung and right upper lung are clear. cardiomediastinal silhouette is difficult to assess given silhouetting on the right. no visualized acute osseous abnormality.
<unk>-year-old male with chest pain and fall.
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the cardiomediastinal and hilar contours are normal. there is no pleural effusion or pneumothorax. the lungs are well expanded and clear without focal consolidation. again seen is suture material overlying both upper lobes medially. median sternotomy wires remain intact. irregularity of the distal body of the sternum may be postsurgical and appear similar to the scout from the chest ct on <unk>.
history: <unk>m with chest tingling.
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no significant change in the persistent, bilateral patchy opacities with air bronchograms, which can be in seen in the setting of ards and multifocal pneumonia. persistent bilateral pleural effusions, perhaps slightly increased in the interim. no pneumothorax. cardiomediastinal silhouette is unchanged.
<unk> year old woman with <unk>'s disease, dchf, atrial fibrillation now with ongoing multifocal infiltrates on cxr, concern for amiodarone toxicity vs. aspiration pna. evaluate for interval change.
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an endotracheal tube is in unchanged position, <num> cm from the carina. an enteric tube courses below the diaphragm with the tip out of field of view. the right internal jugular central venous catheter is present with the tip in the mid svc. again, there are moderate bilateral pleural effusions, similar to the prior exam. bilateral, predominantly perihilar interstitial and parenchymal opacities are similar to the prior exam. there is no new opacity. there is no pneumothorax. the mediastinal contours are normal. the heart size is difficult to determine given the adjacent effusions.
disseminated adenovirus. evaluate for change in pneumonia and pulmonary edema.
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the heart is normal in size. the mediastinal and hilar contours appear within normal limits. there is no pleural effusion or pneumothorax. the lungs appear clear. minimal degenerative changes are noted along the thoracic spine. there is no free air.
nausea and vomiting. status post renal transplant.
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lungs are well-expanded and clear. the cardiomediastinal silhouette is unremarkable. there is no pleural effusion, pulmonary edema, pneumothorax, or focal airspace consolidation. the visualized osseous structures are intact.
history: <unk>f with ili, chest pain // ro pna
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mild to moderate cardiomegaly is re- demonstrated. the mediastinal and hilar contours are similar. mild pulmonary vascular congestion is unchanged, likely chronic, without overt pulmonary edema. no focal consolidation, pleural effusion or pneumothorax is present. no acute osseous abnormalities seen.
<unk> year old woman with copd, chest pain //
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lung volumes are low. there is severe cardiomegaly which has progressed since prior study. the azygos vein is distended. there is obscuration of the left hemidiaphragm which may be due to atelectasis and effusion. there is mild pulmonary vascular congestion. there is no pneumothorax. calcifications of the tracheobronchial tree as well as the aortic arch are noted. visualized upper abdomen is unremarkable.
sepsis, history of heart failure, evaluate for pulmonary edema.
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frontal and lateral chest radiographs demonstrate well-expanded lungs. cardiomediastinal contours are normal. lungs are clear. there is no pleural effusion and no pneumothorax. tiny linear metallic density projecting over the right breast likely represents a biopsy clip. no definite rib fractures.
fall from bicycle, tenderness to palpation over the right shoulder, evaluate for fracture.
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frontal and lateral views of the chest. the cardiac silhouette is enlarged since <unk>, which may reflect either cardiomegaly or a pericardial effusion. the lungs are clear without focal consolidation, pleural effusion, or pneumothorax.
left chest pain.
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ap portable supine view of the chest. right ij central venous catheter has been placed in the interval with its tip in the region of the mid svc. there is no pneumothorax. increased bilateral ground-glass opacities are concerning for edema. no large effusions are seen. the cardiomediastinal silhouette is unchanged. hila appear engorged. bony structures are intact.
<unk>f with r ij pacement, tachycardia
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portable semi-supine radiograph of the chest demonstrates low lung volumes with extensive opacification of the bilateral lungs, right greater than left, the appearance is consistent with multifocal pneumonia versus aspiration. based on retrospective review of radiographs from <unk>, the dramatic change over the course of the day is suggestive of contributions from pulmonary edema and aspiration or pulmonary hemorrhage. cardiomediastinal and hilar contours are unchanged, allowing for differences in patient positioning. there is no pneumothorax. endotracheal tube ends <num> cm from the carina.
<unk>-year-old man with variceal bleed after intubation. evaluate for placement of endotracheal tube.
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the lungs are clear without focal consolidation or effusion. cardiac silhouette appears mildly enlarged but this is likely accentuated by prominent mediastinal fat as seen on prior ct. hypertrophic changes are noted in the spine.
<unk>m with cough // eval infiltrate
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lung volumes are normal. there is no focal consolidation, effusion or pneumothorax. mediastinal and hilar contours are normal. heart size is normal.
history: <unk>f with cough, sob // evaluate for infiltrate
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mild linear opacities in the lung bases have slightly increased can be increasing atelectasis. no pulmonary edema. mild cardiac enlargement. pacer wires in the right atrium and right ventricle. no pleural effusion or pneumothorax.
<unk> year old man with known heart failure, on amioderone // evaluate for amioderone pulmonary toxicity. please send copy of the report to dr. <unk>
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there is minimal linear bibasilar atelectasis. .there is no focal consolidation to suggest pneumonia. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. no rib fractures are identified.
<unk> year old woman with s/p fall // eval rib fxs
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a left subclavian venous catheter terminates in the mid svc. a right port-a-cath 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.
<unk> year old woman with neutropenia, cough // pneumonia
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since <unk>, a new well circumscribed mass-like opacity measuring <num> cm is seen in the left <unk>-<unk> region, adjacent to the operative site. differential considerations include organized hematoma and lung torsion. left basilar atelectasis has improved with unchanged small left pleural effusion. the right lung is clear except for basilar atelectasis. lung volumes remain low. mild cardiomegaly is unchanged. no pneumothorax or pulmonary edema. previously noted subcutaneous emphysema is improved.
<unk> year old man with history of liver cancer s/p left thoracotomy with superior segmentectomy of the left lower lobe with mediastinal lymph node dissection now with cough and fever. // r/o infection. please <unk> <unk> <unk> with wet read. thanks.
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the lungs are free of focal consolidations, pleural effusions or pneumothorax. no pulmonary edema. mediastinum, hila and heart are within normal limits. no acute osseous abnormalities. right axillary surgical clips are redemonstrated. patient is status post left mastectomy with the left implant.
<unk> year old woman with history of left breast cancer status post mastectomy now with decreased exercise tolerance, worsening obstruction on pfts, family hx pulmonary embolus, ordered for v/q scan // pre-v/q scan cxr to evalute for structural, parenchymal abn
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there is biapical scarring and diffuse chronic interstitial changes are seen in both lungs. fibrotic changes in the right lung apex with elevation of the right minor fissure. slightly prominent right hilus. there are left basilar pleural plaques. the cardiomediastinal silhouette is normal. there is no pneumothorax.
<unk>-year-old with tremors, shortness of breath, please assess for pneumonia.
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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.
history: <unk>f with dyspnea on exertion
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tracheostomy ends in the lower thoracic trachea. a right ij line ends at the svc ra junction. a heterogeneous and calcified right lower lobe opacity corresponds to a pleural based mass, unchanged from <unk>. lung fields are clear. heart size is normal. no pneumothorax.
history: <unk>f with r ij placement // eval r ij placement
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when compared to prior, there has been no significant interval change. there is no focal consolidation, effusion, or edema. cardiomediastinal silhouette is stable. degenerative changes noted at the shoulders bilaterally, no acute osseous abnormalities identified.
<unk>f with weakness // eval for pna
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the lungs are clear. there is no consolidation, effusion, or edema. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with cough // infiltrate
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heart size is at the upper limits of normal. aorta is calcified and minimally unfolded. the mediastinal and hilar contours are otherwise within normal limits. no chf, focal infiltrate, effusion or pneumothorax detected. faint hazy opacity at both lung bases peripherally is thought to represent artifact due to overlying soft tissues.
history: <unk>f with cough // r/o acute infectious process
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single portable view of the chest compared to previous exam from <unk>. low lung volumes again noted. increased interstitial markings throughout the lungs are again seen dating back to <unk>. this could be due to chronic underlying lung disease and in part accentuated by portable technique and low lung volumes. there is no confluent consolidation. cardiomediastinal silhouette is within normal limits. osseous and soft tissue structures are unremarkable.
<unk>-year-old male with persistent midsternal chest pain. question infiltrate.
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cardiac silhouette size is mildly enlarged. the aorta is mildly tortuous. mediastinal and hilar contours are within normal limits. pulmonary vasculature is not engorged. lungs are clear. no pleural effusion or pneumothorax is present. deformity of the left seventh posterolateral rib likely reflects a remote fracture. surgical anchor is noted projecting over the right shoulder.
history: <unk>m with pre-op
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the cardiac silhouette remains markedly enlarged, similar to prior. again there is lingular atelectasis/scarring, linear. persistent mild blunting of the right costophrenic angle. no new focal consolidation is seen. no large pleural effusion or pneumothorax. mediastinal contours are stable with a calcified, tortuous aorta.
history: <unk>f with cp and throat pain, worse with swallowing // ? ptx or pna
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there are low lung volumes accounting for some bronchovascular crowding. bibasilar opacities likely represent atelectasis. no other focal opacities are seen. blunting of the left costophrenic angle is secondary to a prominent epicardial fat pad that is better seen in subsequent ct. there is no pleural effusion or pneumothorax. there is no evidence of abdominal free air. a tortuous aorta is present. the cardiomediastinal contour is unremarkable.
<unk>-year-old male with epigastric and substernal pain. evaluate for evidence of free air or pneumothorax.
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the patient is status post median sternotomy and cabg. aside from right basilar atelectasis, the lungs are clear. the hilar and cardiomediastinal contours are normal. there is no pneumothorax. there is no pleural effusion. pulmonary vascularity is normal.
<unk>-year-old woman with recent esophageal dilation, presenting with <num> episode of vomiting and dizziness.
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frontal and lateral chest radiographs again demonstrate moderate cardiomegaly. coarse interstitial markings are unchanged and again suggestive of chronic interstitial lung disease. left base atelectasis is again seen, without new focal consolidation. there is no appreciable pleural effusion or pneumothorax. the visualized upper abdomen is unremarkable.
evaluate for pneumonia in a patient with cough.
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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.
<unk>-year-old female with increasing cough, evaluate for pneumonia.
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the patient is status post recent esophagectomy and pull-up procedure. cardiomediastinal contours are stable. there is no large pleural effusion or pneumothorax. the visualized osseous structures are unremarkable.
history of minimally invasive esophagectomy. please evaluate for interval change.
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frontal and lateral chest radiographs were obtained. no focal consolidation, pleural effusion, pneumothorax or pulmonary edema is seen. there is minimal bronchial wall thickening. heart size is normal. mediastinal contours are normal. no bony abnormality is detected.
<unk>-year-old man with significant smoking history, presents with acute shortness of breath. rule out pneumonia or mass.
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pa and lateral views of the chest are compared to previous exam from <unk>. there is streaky right basilar opacity likely projecting over the spine on the lateral view. elsewhere, the lungs are clear. cardiomediastinal silhouette is normal. osseous and soft tissue structures are unremarkable.
<unk>-year-old male with history of asthma presents with one day of nonproductive cough.
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right-sided port-a-cath in the low svc. the lungs are clear. the cardiomediastinal contours are unremarkable. no pleural effusions or pneumothorax. no displaced rib or pathologic fractures of the thoracic spine.
<unk> year old woman with h/o breast cancer, left, s/p bilateral mastectomies with tissue expander breast reconstruction, now with severe pain around rib cage, please evaluate // please evaluate chest/rib pain
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mild bilateral pleural effusions have worsened since prior. bilateral perihilar, bibasilar opacities, likely component of edema. dependent bibasilar atelectasis. subtle nodular components in the right lung base may represent atelectasis or infiltrate, clinically correlate. increased heart size. mildly increased pulmonary vascularity.
<unk> year old woman with nstemi, systolic heart failure and bibasilar crackles // evaluate for pulmonary edema
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single frontal view of the chest was obtained. a new left internal jugular central catheter terminates in the mid svc. the lungs are clear. no pneumothorax, focal consolidation, or pleural effusion. the heart size and cardiomediastinal contours are normal. rightward deviation of the tracheal contour is chronic and consistent with a known left thyroid lobe goiter.
<unk>-year-old female status post left internal jugular line placement.
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triple lead left-sided pacer device is seen with leads extending to the expected positions of the right new atrium, right ventricle, and coronary sinus unchanged since the prior study. the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with icd fired this am // pm lead palcement
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the pacing unit projects over the left chest with leads in the right atrium and right ventricle. the heart size is within normal limits. the mediastinal contours demonstrate a mildly tortuous aorta with calcified atherosclerotic disease at the aortic knob and descending aorta. lungs are clear of consolidation. there is no pleural effusion or pneumothorax. mild degenerative changes are present in the right glenohumeral joint.
<unk>-year-old female with cough and fever.
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lung volumes are low. a small right pleural effusion persists, overall unchanged. a left pleural effusion is tiny. pulmonary vascular congestion is mild with minimal edema. increased opacity in the right lung base is new from the prior exam and could reflect developing infection appropriate clinical scenario. cardiomegaly is moderate, unchanged. no pneumothorax. median sternotomy wires and mediastinal clips are unchanged. linear opacities projecting over the left lateral midlung are unchanged since at least <unk>, compatible with scarring.
<unk>-year-old man with bradycardia after dialysis. evaluate for pneumonia.
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there is re-accumulation of the right-sided pleural effusion, which is small in size, status post removal of the pigtail catheter. cardiac pacemaker leads are in unchanged positions. cardiac silhouette is again enlarged but stable. the patient is status post median sternotomy and cabg. left lower lobe opacity is consistent with atelectasis. there is mild pulmonary edema. no pneumothorax. compression deformities of the upper lumbar vertebral bodies are again seen.
<unk>-year-old man with confusion. evaluate for infiltrates or chf.
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the heart size, mediastinal, and hilar contours are normal. the lungs are clear without pleural effusion, focal consolidation, or pneumothorax.
<unk>m with chest pain. evaluate for acute process.
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pa and lateral chest radiographs. punctate nodular density in the left mid lung does not have the radiographic appearance of a metastasis and probably is a vessel. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal.
history of melanoma.
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the previously described oval right upper lobe mass appears unchanged. there are linear opacifications of the left upper lobe, which represent fibrosis. 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.
<unk> year old woman with lung cancer s/p mediastinoscopy // please evaluate for pneumothorax
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cardiac silhouette size is normal. the aorta is mildly tortuous but unchanged. the mediastinal and hilar contours are similar, and no pulmonary vascular congestion is present. lungs remain hyperinflated with flattening of the diaphragms. blunting of the costophrenic angles posteriorly on the lateral view appears chronic, and could reflect pleural thickening. no large pleural effusion or pneumothorax is present. linear opacities in the lung bases likely reflect areas of scarring or subsegmental atelectasis. no focal consolidation is identified. there are mild degenerative changes in the thoracic spine. osseous structures are diffusely demineralized.
history: <unk>m with temperature of <num> degrees, hypoxia
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the perihilar consolidation described in <unk> is almost disappeared. there are new linear opacification at the right base, probably linear atelectasis. heart size is top normal. mediastinal silhouette is normal. there is no pleural fluid. tracheostomy tube is in standard placement. left picc is unchanged ending in upper svc no pneumothorax.
<unk> year old man with pulmonary edema, consolidations.
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ap upright and lateral views of the chest provided. lungs are hyperinflated though there is no evidence of pneumonia or chf. no pleural effusion or pneumothorax. heart size is within normal limits. the aorta appears unfolded. imaged osseous structures are intact. prominent calcification at the costochondral junction noted. no free air below the right hemidiaphragm is seen.
<unk>f with doe // sob
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endotracheal tube terminates <num> 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.
subdural hematoma, intubated, evaluate for tube migration.
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the intra-aortic balloon pump appears unchanged in position with the tip approximately at the level of the aortic arch. lung volumes are unchanged. no liver consolidation or pneumothorax seen. no definite pleural effusion seen. pulmonary vascular congestion is seen is a mildly improved compared to the prior study.
<unk> yom w/ pmh of cad (diagnosed on ett), hld, htn, hypothyroidism who recently presented to his private care doctor for abdominal complaints, found to have hemolytic anemia, developed stemi in ed, now s/p lhc showing <num>vcad. // pulled back iabp, looking for interval change
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allowing for technical differences, the radiographic appearance is quite similar. again seen is cardiomegaly, with sternotomy wires and t avr. also again seen is diffuse opacity throughout the right lung, probably alveolar, with scattered air bronchograms, and less pronounced opacity in the left lung, with a combination of vascular plethora and probable areas of alveolar opacity including scattered retrocardiac air bronchograms. no gross effusion.
<unk> year old man with hiv, hfpef and severe mr <unk>/p tmvr, with persistent fevers and pulmonary infiltrates // interval exam
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stable retrocardiac consolidation likely atelectasis, since prior. worsened right basilar, lingular opacities, may represent atelectasis, consider pneumonitis, aspiration in the appropriate clinical setting. stable heart size. mild interstitial prominence in the lower lungs, more prominent, may represent edema. small pleural effusions.
<unk> year old man with recurrent aspiration s/p cervical decompression/fusion, with significant sputum production, now hypoxemic despite high-flow o<num> // please assess for evidence of mucus plugging, pneumonia, or collapse
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right internal jugular central venous catheter has been removed. lung volumes are low. heart size is borderline enlarged but unchanged. the mediastinal and hilar contours are stable. innumerable diffuse pulmonary nodules are re- demonstrated, the largest in the right upper lobe measuring up to <num> mm. patchy left lower lobe opacity likely reflects atelectasis. no focal consolidation, pleural effusion or pneumothorax is present. the pulmonary vascularity is not engorged. multiple clips are re- demonstrated in the left upper abdomen compatible with prior nephrectomy. known osseous metastasis involving the t<num> vertebral body is not well visualized on the current exam.
history: <unk>m with bilateral lower extremity edema, metastatic renal cell carcinoma
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right internal jugular venous catheter is in unchanged position with the tip terminating in the distal svc. a left-sided dialysis catheter is again seen with the tip terminating in the right atrium. heart size is normal. stable, abnormal contour of the left mediastinum could represent a mediastinal mass. recommend chest ct for further evaluation. slight interval increase in right basilar opacity without associated volume loss likely reflects consolidation. there is no pneumothorax or pleural effusion.
<unk>-year-old woman with concern for aspiration pneumonia.
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a tracheostomy is in-situ, unchanged in appearance compared to the prior study. lung volumes are low, this limits assessment. a right-sided picc terminates in the mid to distal svc. a ventriculoperitoneal shunt is incompletely visualized. an ivc filter is seen in the upper abdomen. a gastrostomy tube is incompletely visualized. even allowing for the projection, the heart is enlarged. bilateral airspace opacities are again seen. this is more confluent in the right upper lobe than on the prior study. appearances remain concerning for infection.
<unk> year old woman with trach, on vent // interval changes
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exam is limited secondary to patient's positioning with his chin overlying is lung apices bilaterally. when compared to prior, there is increased opacity in the left hemi thorax. there is also probable right pleural effusion and pulmonary edema.
<unk>m with sob // eval for pna ptx
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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.
upper respiratory tract infection symptoms x<num> weeks, now with dizziness and productive cough.
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the cardiomediastinal and hilar contours are within normal limits. lungs are well expanded and clear. there is no focal consolidation, pleural effusion or pneumothorax.
chest pain. evaluate for pneumothorax, chf.
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the cardiac, mediastinal and hilar contours appear stable. there is no pleural effusion or pneumothorax. the lungs appear clear.
chest pain and abnormal ekg.
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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. note is made of a soft tissue calcification lateral to the left humeral head.
history of seizures, please evaluate for pneumonia.
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the lungs are clear. hila and mediastinal contours and pleural surfaces are normal. heart size is top-normal.
<unk> year old man with cough , wheeze x <num> days, vol overload on exam // eval for chf / infiltrate
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frontal and lateral views of the chest were obtained. there is no focal consolidation, pleural effusion, or pneumothorax. heart size is normal. mediastinal silhouette and hilar contours are normal. marked interstitial prominence is unchanged from <unk>. two lower lung nodules are prominent nipple shadows as seen on <unk>.
<unk>-year-old man with four days of cough and purulent sputum.
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previously noted picc line has been removed. focal eventration of the left hemidiaphragm again noted. lungs are clear. no focal consolidation, large effusion, pneumothorax or signs of congestion/edema. cardiomediastinal silhouette stable. aortic arch calcifications are again noted. degenerative changes in the spine are noted.
<unk>m with orthostasis. infectious r/o.
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lung volumes are low. there is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. the cardiomediastinal silhouette is within normal limits.
<unk>f with chest pain and palpatiation, doe // please assess for consolidation, effusion, edema
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lungs are clear. the cardiomediastinal silhouette is normal. no acute osseous abnormalities.
<unk> with fevers // infiltrate?
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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. scoliosis is similar to prior. no free air below the right hemidiaphragm is seen.
history: <unk>m with parkinsons, here w/ altered mental status, please eval for pna // pneumonia