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MIMIC-CXR-JPG/2.0.0/files/p16289699/s55870377/f5bc0fd4-c73df70d-b2760172-59accdb9-161fbc14.jpg
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the patient is status post cabg and median sternotomy. left-sided aicd device is noted with leads terminating in the right atrium, right ventricle, and coronary sinus, unchanged. moderate cardiomegaly persists. the mediastinal and hilar contours are stable, with calcification of the thoracic aorta again demonstrated. mild pulmonary vascular congestion persists. a small right pleural effusion persists, slightly decreased in size compared to prior chest radiograph. right basilar atelectasis is noted. subtle bilateral upper lobe nodular opacities which are better seen on the prior ct persist, and may reflect an infectious or inflammatory process. no new focal consolidation is identified. there are no acute osseous abnormalities.
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weakness.
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ap upright and lateral views of the chest provided. a calcified granuloma is again seen projecting over the right mid lung. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. chronic left ribcage deformities are unchanged. severe right glenohumeral joint disease is noted. no free air below the right hemidiaphragm is seen.
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<unk>m with cough, elevated lactate // evidence of pneumonia
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low lung volumes are stable with increased prominence of linear atelectasis the left lung base. the vascular pedicle has decreased in size and there is slightly decreased pulmonary vascular congestion although mild interstitial edema remains. no pleural effusion, pneumothorax, or focal consolidation.
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<unk> year old woman with spina bifida, seizure disorder, recent uti, presenting with denuding skin and hypoxia // eval for hypoxia
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interval resolution of the patchy opacifications bilaterally and lungs appear clear. cardiac size is normal. there is no pneumothorax or pleural effusion. dual-chamber dialysis catheter with tip in the cavoatrial junction.
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<unk> yo m with a history of ?psychotic break in last <unk> years, l tibial fracture with orif, ckd (<unk> nsaids) and hypercalcemia with multiple sequelea (arf, calciphelaxisis) due to excessive vit d consumption who present with lle pain found to be septic with grossly infected lle hardware now s/p partial removal of hardware with retained intramedullary rod, on iv antibiotics for <num> weeks +rifampin. also with hypercalcemia in the setting of vit d/calcium ingestion, treated with fluids, lasix, calcitonin, denosumab. also with acute renal failure, requiring hd (last on <unk>), now with good uop but high <num>s-<num>s.
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pa and lateral views of the chest provided. aicd is unchanged in position with lead extending to the right ventricle. there is a similar pattern of scattered linear opacities likely reflecting scattered areas of atelectasis. there is mild prominence of the central hilar vasculature, not significantly changed without frank pulmonary edema. there may be a small right pleural effusion. no pneumothorax. heart size is unchanged. bony structures appear grossly intact.
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<unk>m with sob/sscp radiating down left arm with extensive cardiac history including cabgx<num> and icd. // evidence of chf exacerbation?
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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 <unk> and is likely an extensive fat pad.
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<unk> year old man with cough, r base rales. assess for pneumonia.
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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.
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<unk> 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
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cardiac size is normal. mediastinal contours are stable. right shunt catheter is again noted. left subclavian catheter tip is in the lower svc unchanged. aside from linear left lower lobe atelectasis, the lungs are clear. there is no pneumothorax or pleural effusion.
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<unk> year old woman with anorexia // abnormality?
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frontal and lateral views of the chest. large right perihilar mass is again seen and not significantly changed. more extensive streaky right basilar opacities are seen which may be due to atelectasis, especially given relative elevation of the right hemidiaphragm perhaps slightly more so than on prior. tracheal stent is identified. the left lung is grossly clear. the cardiomediastinal silhouette is unchanged. no acute osseous abnormalities.
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<unk>f with tumor burden, recent y stent placement.
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the lung volumes are low. no focal opacity, pulmonary edema, pleural effusion or pneumothorax. the cardiac and mediastinal contours are normal.
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history: <unk>m with cp and dyspnea // eval cardiomegaly, infiltrate
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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.
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history: <unk>f with history of hypertension and asthma with one episode of shortness of breath.
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a single portable chest radiograph was obtained. the lungs are well expanded and clear. there is no focal consolidation, effusion, or pneumothorax. cardiac and mediastinal contours are normal. the tip of a right-sided picc line terminates in the svc.
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rising white blood cell count.
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right picc line tip not well seen, probably near cavoatrial junction. increased heart size, pulmonary vascularity, mildly improved. improved pulmonary edema. sternotomy. support devices in place. mild to moderate left pleural effusion has improved. there is small right pleural effusion, similar to improved.
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<unk> year old man with picc, out <num>-<num>cm from last documented // ?placement
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compared one day earlier and allowing for differences in technique, there has been possible slight interval improvement at the right and left lung bases, with suggestion of increased lucency at both lung bases. otherwise, i doubt significant interval change. note is made of a tapered, well corticated appearance to the right distal clavicle --<unk> there history of prior surgery to account for this?
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<unk> year old woman with ?pna, pulmonary fibrosis, afib w/rvr,now with tachypnea/tachycardia // any interval change? pulm edema?
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heart size is normal with dense mitral annular calcifications again seen. mediastinal and hilar contours are unchanged. the pulmonary vasculature is not engorged. lung volumes are low with patchy opacities in the lung bases, not substantially changed from the prior study, and most likely suggestive of atelectasis. no focal consolidation, pleural effusion, or pneumothorax is present. hypertrophic changes are re- demonstrated in the thoracic spine.
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history: <unk>f with failure to thrive
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bibasilar opacities, left greater than right, likely represent a combination of pleural effusion and atelectasis, however pneumonia could be considered in the appropriate clinical setting. the cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax. free air beneath the right hemidiaphragm is consistent with recent postoperative status.
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history: <unk>m with fever s/p appendectomy // eval for atelectasis, pneumonia
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portable frontal chest radiograph demonstrates new tracheostomy projecting over the midline. no pneumothorax or pneumomediastinum. worsening bibasilar atelectasis without definite focal consolidation. no pleural effusion. heart size is normal. left picc line terminating in the upper svc.
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<unk>-year-old female with altered mental status now vent dependent status post tracheostomy.
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the cardiomediastinal and hilar contours are at the upper limits of normal. the lungs are clear of consolidation. there is no pleural effusion or pneumothorax.
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<unk>-year-old female with new hypoglycemia.
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compared to <num> hours prior, there has been interval placement of an enteric tube terminating in the distal neo esophagus. enteric contrast is no longer present. mid and lower right lung predominant opacities have increased. otherwise, no significant change.
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<unk> year old man s/p esophagectomy // interval change
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cardiac silhouette size remains mildly enlarged, unchanged. mediastinal and hilar contours are within normal limits. pulmonary vasculature is normal. lungs are clear. no focal consolidation, pleural effusion or pneumothorax is present. no acute osseous abnormality is visualized.
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<unk>m with left arm and leg numbness
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as compared to the previous radiograph, metallic structure projecting over the upper parts of the right upper hemithorax are unchanged in position. minimal hyperlucencies at both lung apices are compatible with underlying pulmonary emphysema as noted on prior ct of <unk>. no pneumothorax is detected. there is interval focal consolidation at the left lower lobe from <unk>, compatible with pneumonia. the cardiac silhouette is normal in size. the mediastinal contours are within normal limits with unchanged calcification of the aortic knob and minimal tortuosity of the thoracic aorta.
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history of squamous cell carcinoma of the lung, now with fever, here to evaluate for pneumonia.
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the lungs are clear besides mild left basilar atelectasis. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
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<unk>f with cp // ?cause of cp
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pa and lateral views of the chest provided. port-a-cath projects over the right axilla with catheter tip in the region of the mid svc. lungs are clear. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. a small retrocardiac density containing air lucency likely represents a small hiatal hernia. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
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<unk>m with h/o gastic ca w. fatigue, fever // pna
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ap portable upright view of the chest. lung volumes are markedly low limiting assessment. there is a retrocardiac opacity containing an air-fluid level compatible with a large hiatal hernia. there is subtle left lower lung hazy opacity which is potentially concerning for pneumonia or aspiration. the right lung appears relatively clear. no large effusion or pneumothorax is seen. heart size is difficult to assess. mediastinal contour appears prominent likely due to technique. no acute bony abnormality seen.
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<unk>m with hypoxia // eval for infiltrate
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ap upright and lateral views of the chest provided. patient has calcified pleural plaque along the right lower hemi thorax which accounts for the triangular opacity noted. the heart is mildly enlarged. hila appear congested. there may be mild interstitial edema. no convincing signs of pneumonia. no large effusion or pneumothorax. bony structures appear grossly intact.
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<unk>f with n/v/d, f/c, renal transplant/immunosuppressed // r/o infiltrate
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the lungs are clear. cardiac silhouette is mildly enlarged. there is no pleural effusion, pneumonia or pulmonary edema. left lower lobe opacity corresponds to the prominent epicardial fat pad. bones are intact.
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fatigue, elevated white blood cell count.
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there are relatively low lung volumes. no definite focal consolidation is seen. no pleural effusion or pneumothorax is seen. cardiac silhouette size is top-normal, likely exaggerated by low lung volumes. mediastinal contours are unremarkable. no pulmonary edema is seen. subtle irregularity at the lateral left third rib is felt to be due to overlap of structures. correlate with focal tenderness at this site for possible nondisplaced fracture.
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history: <unk>f with chest pain and cough. also with right leg pain after fall from standing. // eval for pneumonia, fracture/dislocation
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the lungs are clear. the cardiomediastinal silhouette is normal. no acute osseous abnormalities identified.
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<unk>f with hx of stroke p/w facial numbness and right arm tingling. // please assess for acute cardipulmonary process, or tumor
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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.
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<unk>-year-old female with cough, fever and left leg pain. evaluate for pneumonia.
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the lungs are mildly hyperinflated and clear. there is no pleural abnormality. the heart is top-normal in size. the mediastinum and hilar contours are normal. thoracic kyphosis and compression deformities of the mid thoracic vertebra are unchanged compared to prior.
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<unk> year old woman with cough, asthma exacerbation, ongoing sx x <num> months. evaluate for pneumonia.
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<num> views of the chest demonstrate mild bibasilar atelectasis with slightly hyperinflated lungs. the mediastinal contour is slightly prominent due to unfolding of the aorta. the cardiac size is normal and the hilar contours are within normal limits. no pneumothorax or pleural effusion.
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wheezing and chest pain.
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et tube terminates <num> cm above the carina. lung volume is improved and bibasilar consolidation is decreased. pulmonary edema is improved. cardiomediastinal silhouette is unchanged. ng tube extends beyond the inferior edge of the film. free air in the abdomen outlines the transverse colon, which is expected from recent abdominal surgery.
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<unk> year old man with ett // ett position
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frontal and lateral radiographs of the chest. the study is somewhat limited by soft tissue attenuation. stable mildly enlarged heart siz. the mediastinal and hilar contours are normal. no focal consolidation. no definite pleural effusion or pneumothorax. persistent mild vascular congestion.
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chills and cough question pneumonia.
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the cardiomediastinal and hilar contours are normal. the lungs are clear. there is no pleural effusion or pneumothorax.
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<unk>-year-old male with fevers for <num> days.
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the lungs are well inflated and clear. there is no focal atelectasis, pleural effusion, or consolidation. no pneumothorax. osseous structures are intact. no radiopaque foreign body is visualized.
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history: <unk>f with chicken bone // acute process
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there are low lung volumes. no focal consolidation, pleural effusion, or evidence of pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. no displaced fracture is seen.
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chest pain.
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slightly low lung volumes, perhaps related to degree of respiratory effort. the lungs are otherwise clear. no focal consolidation, edema, effusion, or pneumothorax. scoliosis of the thoracolumbar spine is overall unchanged. the cardiomediastinal silhouette is normal.
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<unk>-year-old woman presenting with chest pain. evaluate for acute process.
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pa and lateral views of the chest. the lungs are clear of consolidation or effusion. enlarged cardiac silhouette and prominence of the main pulmonary artery contour are again noted. no acute osseous abnormality detected.
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<unk>-year-old female with chest pain and fever.
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cardiac size is top normal. et tube is in standard position. ng tube tip is out of view below the diaphragm. . there is no pneumothorax or pleural effusion. there is mild vascular congestion. new widening of the mediastinum could be due to engorgement of the vessels, attention in followup is recommend. perihilar opacities and left lower lobe opacities are likely atelectasis, aspiration should be considered
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<unk> year old man with hypovolemic shock, now intubated // ogt placement
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size of the patient's left apical pneumothorax is unchanged very slightly slightly smaller compared to yesterday's study. taking into account differences in obliquity, there is no significant interval change in the appearance of the lungs or the heart and mediastinal contours. no central pulmonary vascular congestion is seen. healed posttraumatic changes at the proximal humerus and acromioclavicular joint appear stable.
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<unk> year old woman with known left apical pneumothorax, hypotension likely from other causes but want to rule out enlarging tension ptx // evaluate for pneumothorax progression
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left paratracheal anterior mediastinal and paucity is worrisome for mediastinal mass. no focal consolidation is seen. there is no pleural effusion or pneumothorax. cardiac silhouette is not enlarged.
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history: <unk>f with lupus p/w fever, hypotension and <num> weeks of vomiting and weight loss and abdominal pain // ?intra-abdominal process
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a left-sided pacemaker and leads are in appropriate position. heart size is mildly enlarged. the mediastinal and hilar contours are unremarkable. the pulmonary vasculature is normal. lungs are hyperinflated without focal consolidation. streaky opacities at both lung bases likely reflect atelectasis. the bronchial tree is calcified and there is mild dilatation of the bronchi particularly in the lung bases suggestive of bronchiectasis. no pleural effusion or pneumothorax is seen. deformity of the right-sided ribs likely reflect remote rib fractures. no acutely displaced fractures seen.
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history: <unk>f with fall now with rib rib pain // r/o right rib fractures, pna
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nasogastric tube courses below the level of the diaphragm and terminates in the region of the stomach. the cardiomediastinal and hilar contours are within normal limits. the lung fields are clear. there is no pneumothorax, fracture or dislocation. there is gaseous distention of a loop of small bowel in the left upper quadrant of the abdomen.
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history: <unk>f with ? sbo now w/ ngt placement // eval ? ngt placement
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a new feeding tube is seen in the stomach. mild curvilinear opacification is seen above the right hemidiaphragm and may represent some atelectasis. heart size is top normal. no pneumothorax or pulmonary edema.
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<unk> year old man with new ngt placement // ngt placement
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there is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. the heart size is normal. mediastinal contours are normal.
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episode of choking, evaluate for aspiration.
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heart size is normal. mediastinal and hilar contours are unremarkable. the pulmonary vascularity is normal. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is present. no acute osseous abnormality is present.
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hypoglycemia, altered mental status.
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left-sided pacemaker device is noted with single lead terminating in the right ventricle. heart size is mildly enlarged. aorta is tortuous. the mediastinal and hilar contours are otherwise unremarkable. the pulmonary vasculature normal. streaky opacities in the lung bases are compatible with atelectatic changes. no focal consolidation, pleural effusion or pneumothorax is identified. multilevel degenerative changes are noted in the thoracic spine.
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altered mental status.
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heart size is mildly enlarged. the mediastinal and hilar contours are unremarkable. previous pattern of mild pulmonary ocular congestion has essentially resolved. no focal consolidation, pleural effusion or pneumothorax is seen. there is minimal streaky atelectasis in the lung bases. calcified granuloma is again noted within the right lung base. no acute osseous abnormalities seen.
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history: <unk>m with recent admission for multifocal pneumonia, presents with shortness of breath
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chest pa and lateral radiograph demonstrates unremarkable mediastinal and hilar contours. stable enlarged cardiac silhouette. minimal bibasilar atelectasis is relatively unchanged compared to next preceding study. otherwise, lungs are clear. no pleural effusion or pneumothorax evident. no osseous abnormality identified.
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history of pulmonary hypertension, wheezing, shortness of breath, please evaluate for cardiopulmonary process.
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frontal and lateral chest radiographs demonstrate unchanged mild to moderate cardiomegaly and mild pulmonary edema. there is no focal consolidation, pleural effusion, or pneumothorax. the visualized upper abdomen is unremarkable.
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evaluate for infiltrate in a patient with a seizure aura.
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right upper lobe radiation changes are grossly stable given differences in modality from the prior study. the volume loss in the right upper lobe causes shifting of the mediastinum to the right. otherwise, the mediastinum as well as the cardiac size are stable. the right hilar adenopathy was better seen on the prior pet. blunting of the lateral right costophrenic angle is likely from pleural thickening. the left lung is clear. there is no pleural effusion or pneumothorax.
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<unk>-year-old female, on chemo, and fevers. question pneumonia.
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cardiomediastinal contours are normal. the upper lungs are clear. there is no pneumothorax . the osseous structures are unremarkable small bilateral pleural effusions are associated with adjacent atelectasis
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<unk> year old woman with decreased breathe sounds and fever on post-op day <num> // atelectasis, pneumonia?
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pa and lateral views of the chest provided. clips noted in the upper abdomen. 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.
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<unk>f with weakness and dizziness // r/o pna r/o chf
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calcification demonstrated in the region of the aortic arch can be correlated to calcified lymph nodes on concurrent ct examinations, stable since <unk>. there is mild stable left apical scarring. there are no focal opacities concerning for pneumonia. there are no pleural effusions or pneumothorax. the cardiomediastinal and hilar contours are normal. pulmonary vascularity is normal. there are findings compatible with diffuse idiopathic skeletal hyperostosis.
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this is a <unk>-year-old male with altered mental status.
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when compared to chest radiograph dated <unk>, this frontal and lateral radiograph is unchanged. the lungs are well expanded and clear. the cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax or pleural effusion.
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<unk>-year-old female with fever cough and wheezing. evaluate for infiltrate.
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ap single view of the chest has been obtained with patient in upright position. comparison is made with the next preceding similar study obtained eight hours earlier during the same day. permanent pacemaker with icd device, cardiac enlargement and pulmonary congestion as before. during the interval, the left-sided chest tube has been removed. no pneumothorax is seen in the apical area of the left hemithorax. no new parenchymal densities can be identified. the markedly congested pulmonary vascular pattern persists and may have increased slightly.
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<unk>-year-old female patient with pericardial window placed yesterday. chest tube pulled today, evaluate for possible pneumothorax.
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increased patchy opacifications in the left mid and lower lung zones as well as possibly the right lower lung, likely reflect pneumonia, possibly lingula with some involvement of the right lung base. mediastinal, hilar and cardiac contours are unremarkable. no pleural effusion or pneumothorax evident. no osseous abnormality is identified.
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cough, shortness of breath, please evaluate for pneumonia.
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pa and lateral images of the chest. a right dialysis catheter terminates in the cavoatrial junction. the lungs are well expanded and clear. there is no focal consolidation or mass. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is unremarkable.
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aml, fever, concerning for consolidation.
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the heart size is normal. the aorta is mildly tortuous and demonstrates atherosclerotic mural calcifications at the aortic arch. the hilar contours are normal. there is mild pulmonary vascular congestion. blunting of the costophrenic angle on the right is compatible with a trace pleural effusion. the lungs are hyperinflated. there is scarring within the lung apices. no focal consolidation is identified, and there is no pneumothorax. diffuse demineralization of the osseous structures is noted.
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shortness of breath and pedal edema.
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the patient is status post posterior spinal fusion of the upper thoracic spine with an interbody spacer. there is a right-sided picc line which terminates in the mid right atrium. the lungs are well inflated. linear opacities at the left lung base and along the posterior aspect of the lungs on the lateral view are slightly worse compared to the prior radiograph from <unk>, but have a waxing and waning appearance over other prior imaging studies. this could represent fluctuating atelectasis. there is no strong evidence for pneumonia. osseous structures are intact. heart size and mediastinal contours are normal.
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history: <unk>m with fever // pna?
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there has been interval placement of an endotracheal tube with the tip terminating <num> cm above the carina. there is interval decreased dilatation of the trachea from the most recent prior radiograph. the lung volumes remain low with increased opacification at the left lung base greater than the right which may represent substantial atelectasis but potentially pneumonia in the appropriate setting. the lung volumes are increased with somewhat better aeratation especially at the left lung base. tortuosity and calcification of the thoracic aorta is re-demonstrated. the cardiac silhouette is incompletely evaluated. surgical clips in the right upper quadrant of the abdomen are compatible with prior cholecystectomy. surgical clips are also noted at the left hemidiaphragm and in the left upper quadrant of the abdomen.
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dyspnea and hypoxia status post intubation, here to evaluate et tube placement.
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there has been no significant interval change. evidence of old lateral right-sided rib fractures is again seen. no focal consolidation is seen. there is no pleural effusion or pneumothorax. thin linear radiopaque structure projecting over the posterior inferior thorax at the level of the posterior diaphragms, best seen on the lateral view was also present on the prior study from <unk> and ct from <unk> and seen to be intimately associated with right-sided posterior ninth rib.
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history: <unk>m with iddm, l foot ulcer presenting with vomiting. // eval for acute process, foot osteomyelitis
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the heart is not enlarged. aorta is calcified and minimally unfolded. the mediastinal and hilar contours are otherwise within normal limits for age. no chf, focal infiltrate or effusion is identified. no pneumothorax is detected. the right hemidiaphragm is slightly elevated.
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history: <unk>m with cough // ?pneumonia
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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.
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<unk>m with chest pain // evaluate for acute process
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a <num>-mm nodule is seen within the right upper lung, just superior to the minor fissure, new compared to chest radiographs from <unk>. the lungs are clear. the cardiac and mediastinal contours are normal. there are no pleural effusions. no pneumothorax is seen.
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chest pain. evaluate for acute process.
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ap single view of the chest has been obtained with patient in semi-upright position. analysis is performed in direct comparison with the next preceding similar study obtained seven and a half hours earlier during the same day. status post sternotomy, tracheal intubation and right-sided internal jugular approach central venous line unchanged. cardiac enlargement unaltered. the on previous examination existing basal haze on the right side has decreased and a local basal air-fluid level is now identified indicating successful thoracocentesis diminishing right-sided pleural effusion which was partially layered in posterior pleural compartments in this patient in almost supine position. left hemithorax remains unaltered. there is no evidence of any pneumothorax in the apical area. position of ng tube unchanged.
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<unk>-year-old female patient status post type a thoracic aorta dissection repair, evaluate for pneumothorax status post thoracocentesis.
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pa and lateral views of the chest are compared to previous exam from <unk> and chest ct from <unk>. postoperative changes of right upper lobectomy are again seen. there is superior retraction of the hila with increased density in this region, similar to previous exam. there is no confluent consolidation or effusion. cardiomediastinal silhouette is stable. osseous and soft tissue structures are unremarkable.
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<unk>-year-old male with chest pain.
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post left lobectomy with slight increased prominence of postsurgical scarring from previous examination. interval increased reticular infiltrate and honeycomb appearance of the right lung base. pectus excavatum deformity.
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<unk> year old woman with history of lung cancer, recently hospitalized in <unk> for "pneumonia // ? pneumonic process
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allowing for projection the heart is within normal limits in size. the aortic knob is slightly prominent. the pulmonary vessels are not congested. there are no pulmonary opacities. no pleural effusion. left subclavian line in svc. nasogastric tube in stomach.
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<unk> year old woman with fever // pna, fever
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as compared to prior examination, there has been minimal interval change. redemonstrated is elevation of the right hemidiaphragm. there is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. the heart size is normal. the aorta is noted to be mildly tortuous. mediastinal contours are otherwise normal.
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productive cough.
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right internal jugular central venous catheter tip terminates in the mid svc. no pneumothorax is present. moderate cardiomegaly is again noted. the mediastinal and hilar contours are unchanged. there is mild pulmonary vascular congestion, new since the prior study. there continued bibasilar patchy airspace opacities, not substantially changed in the interval. no large pleural effusion is present.
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history: <unk>f with right ij cvl
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the patient is rotated and bending to the right, severely distorting the thoracic cage and appearance of mediastinal structures. visualized portions of the lungs are essentially clear other than lower lobe platelike atelectasis and are scarring bilaterally, similar to prior exam. the heart size appears normal. thoracic aortic calcifications are unchanged. no pneumothorax or pleural effusion. no evidence of an acute osseous abnormality.
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<unk>-year-old man with parkinsons with garbled speech and right sided facial droop. evaluate for any acute process, please perform prior to transfer to the floor.
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ap semi upright and lateral views of the chest provided. left chest wall aicd is again seen with leads extending to the region of the right atrium, coronary sinus, and right ventricle as on prior. midline sternotomy wires and mediastinal clips again noted. lung volumes are low limiting assessment. there is subtle retrocardiac opacity which could represent a developing pneumonia or aspiration. there is mild right basal atelectasis with mildly elevated right hemidiaphragm. no overt edema. no pneumothorax or definite signs of effusion. cardiomediastinal silhouette is stable. chronic right rib cage deformities again noted. no acute fracture is seen.
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<unk>m with ams
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lung volumes are low. there is secondary crowding of the bronchovascular markings. there is also engorgement of the central pulmonary vasculature when compared to prior. there is no focal consolidation or large effusion. cardiac silhouette is stable. no acute osseous abnormalities.
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<unk>f with sickle crisis, prev negative cxr, now w/ wbc <unk>, hypoxic to <unk>'s, febrile to <num>, in pain, question acute chest.
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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.
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history: <unk>f with chest pain
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pa and lateral views of the chest provided. lungs appear hyperinflated with flattened diaphragms. there is mild linear atelectasis at the left lung base. there is no worrisome consolidation, effusion or pneumothorax. no congestion or edema. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
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<unk>m with cp // eval for cause of cp
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moderate cardiomegaly and pulmonary vascular congestion are similar to the prior study. hazy opacifications the posterior sulcus is also unchanged from multiple prior studies and previously characterized as atelectasis and small pleural effusions on cta of the chest dated <unk>.
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<unk>m with sickle cell disease and desaturation, evaluate for pneumonia or edema.
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compared to the prior study, the small left pneumothorax is similar, possibly very slightly smaller. again seen is subsegmental atelectasis and blunting of the left costophrenic angle, very slightly more pronounced. the left-sided pigtail catheter is again seen, similar to the prior study. relative lucency of the upper and mid zones of the left lung are unchanged. rightward shift of the cardiac silhouette is also unchanged. the right lung remains grossly clear, without pneumothorax
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<unk> year old man with spontaneous pnx // interval change
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lungs are clear. no pleural effusion, pneumothorax or focal airspace consolidation. heart is normal size. no pulmonary edema mediastinal and hilar contours are unremarkable. clips are seen in the left breast and region of the gallbladder.
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chest pain. evaluate for pneumonia.
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pa and lateral images of the chest were obtained. right middle lobe pleural effusion, seen as a round opacity contiguous with the minor fissure, has significantly increased in size since previous imaging. the previously seen left lower lobe opacity, which likely represents a loculated pleural effusion, has also increased in size since previous imaging. bibasilar pleural effusions are seen. there is no pneumothorax. cardiomediastinal silhouette is unchanged. visualized osseous structures are unremarkable.
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<unk>-year-old female with left pleural effusion.
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frontal and lateral chest radiographs demonstrate slightly decreased lung volumes with prominence of the cardiac silhouette and bronchovascular crowding. even allowing for this, the cardiac silhouette is likely top normal to mildly enlarged in size. a retrocardiac opacity likely represents pneumonia. there is no pleural effusion or pneumothorax. the visualized upper abdomen is unremarkable.
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evaluate for pneumonia in a patient with cough and wheeze.
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enteric tube extends below the diaphragm with the tip out of view of this film. left-sided subclavian line terminates at the upper svc. the et tube is relatively low, approximately <num> cm above the carina. the left-sided pic line terminates at the left axillary vein, unchanged in position compared to the prior exam. right perihilar opacities are unchanged, however there has been an interval increase in the left perihilar opacities, which may be secondary to pneumonia or atelectasis. left sided pneumomediastinum is new. there is no large pleural effusion. the visualized osseous structures are unremarkable.
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history of motor vehicle accident status post splenectomy and compressive craniectomy for cerebral edema. please evaluate for interval change.
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heart is normal size and cardiomediastinal silhouette is stable. there is increased subtle hazy opacification in the left lower lung, best seen on the frontal view. previously noted diffuse bilateral prominence of the interstitial markings has slightly improved. there is no pleural effusion or pneumothorax.
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history: <unk>f with hiv off meds, crack use, presents with confusion and cough with grey phlegm // question for pna
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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.
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<unk>m with atypical chest pain // eval for ptx
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pa and lateral views of the chest demonstrate chronic appearing opacities in the right lower lobe as well as elevation of the right hemidiaphragm. these findings are consistent with atelectasis/volume loss. the left lung is essentially clear. the cardiac silhouette is normal in size. there is tortuosity of the aorta. in addition, a convex bulge of the left upper mediastinum is once again present, but this is due to vascular structures and aberrant subclavian artery as was seen on the recent ct.
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chest pain.
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frontal and lateral views of the chest. when compared to prior, there has been near complete resolution of the previously seen small pleural effusions. the lungs are clear without pulmonary vascular congestion. left chest wall dual-lead pacing device is seen in unchanged position. cardiomediastinal silhouette is within normal limits noting slight rotation to the right. no acute osseous abnormality is detected. hypertrophic changes seen in the spine.
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<unk>-year-old male with hypertension.
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cardiac, mediastinal and hilar contours are normal. the pulmonary vasculature is normal. streaky opacity within the right lower lobe is concerning for an infectious process. no pleural effusion or pneumothorax is seen. sclerotic foci within the mid thoracic vertebral bodies appear similar compared to the previous exam.
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cough for <num> week.
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the endotracheal tube is unchanged in position, although the carina is not well seen on this study. the right subclavian line ends in the mid svc, and the right picc ends in the lower svc. the new dobbhoff tube ends with the tip just beyond the diaphragm in the proximal stomach. otherwise, pulmonary vascular congestion is unchanged with bibasilar atelectasis. cardiac and mediastinal silhouettes and hilar contours are stable.
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<unk>-year-old man, status post dobbhoff tube placement.
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lung volumes are decreased, accentuating the cardiac silhouette and bronchovascular structures. there is bibasilar atelectasis . no large pleural effusions appreciated on this portable radiograph. there is no pneumothorax.
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title history of liver cirrhosis presenting with increased shortness of breath and ascites.
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the cardiac, mediastinal and hilar contours appear unchanged allowing for differences in technique. on the left, there is a small pleural effusion with adjacent areas of band-like opacity suggesting coinciding atelectasis. elsewhere, the lungs appear clear. surgical clips project over the left upper quadrant of the abdomen. the bones appear demineralized.
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fluid overload.
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ap view of the chest. patient is markedly rotated. endotracheal tube ends at the thoracic inlet in the carina. left-sided pacemaker is again seen. the median sternotomy wires are unchanged. an enteric tube ends in the stomach. there is pulmonary vascular congestion. heart size is not well evaluated. <unk> be small bilateral pleural effusions. there is no pneumothorax.
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status epilepticus and intubation.
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there is moderate hyperinflation of the lungs. the cardiomediastinal silhouette and hila are normal. there is no pleural effusion and no pneumothorax. there is no focal consolidation.
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<unk>-year-old woman with altered mental status, please evaluate for pneumonia.
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ap upright and lateral views of the chest provided. there is a moderate right pleural effusion with associated compressive atelectasis in the right lower lung. difficult to exclude an underlying pneumonia. the heart is mildly enlarged. the left lung appears grossly clear. no overt signs of edema. no pneumothorax. mediastinal contour is normal. bony structures are intact. clips in the right upper quadrant noted.
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<unk>m with hyperglycemia
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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.
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history: <unk>f with chest pain, now resolved. // please evaluate for cardiomegaly, effusion, other intrathoracic process.
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portable chest radiograph demonstrates interval removal of right chest tube with no pneumothorax. there are bilateral basal opacities consistent with multi focal pneumonia which appear worse when compared to <num> day prior. there is a right pleural effusion. the cardiomediastinal silhouette is unchanged. a left picc is seen terminating in the mid svc.
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<unk>-year-old female with multi focal pneumonia with right chest tube displacement.
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the lungs are clear without consolidation, effusion, or edema. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities. no focal osseous abnormality identified.
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<unk>f w/dementia, presenting with agitation, right base crackles on exam, please eval for pna
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the lungs are hyperinflated without focal opacities. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.
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<unk>-year-old male with productive cough and fever. evaluate for evidence of pneumonia.
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chronic pulmonary vascular engorgement and cardiomegaly appear unchanged. chronic left lower lobe collapse persists; left pleural effusion cannot be excluded. small right pleural effusion is stable. aortic calcification is again noted. no pneumothorax is detected. the left picc continues to course into the right atrium. right chest tube appears similarly positioned. left humeral deformity is chronic.
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<unk>-year-old female with chronic chylothorax status post pleurodesis, chest tube and pleural catheter placement.
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MIMIC-CXR-JPG/2.0.0/files/p13224377/s51343101/cd255d2a-eb46896b-463e8583-b873ab34-154932ec.jpg
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the endotracheal tube remains appropriately positioned, ending <num> cm above the level of the carina. there are two enteric catheters, one of which ends within the lower esophagus (an esophageal balloon per the coverage physician's report) and the other of which passes below the level of the diaphragm and out of the field of view inferiorly. a left-sided subclavian central venous catheter ends near the superior cavoatrial junction, unchanged. dense left retrocardiac opacification is likely atelectasis, unchanged. moderate pulmonary edema has essentially resolved. patchy opacities in both lower lungs persist. the heart is normal in size. the mediastinal contours are normal. there are no definite pleural effusions. no pneumothorax is seen.
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acute respiratory distress syndrome. evaluate for interval change.
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MIMIC-CXR-JPG/2.0.0/files/p19683840/s58982469/02c610bc-9bf0af53-230c83c5-cdccda31-9f262f5c.jpg
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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.
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history: <unk>f with new ett // ett? ett?
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