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the lungs are well expanded and clear. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.
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patient with fever and cough. evaluate for pneumonia.
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ap single view of the chest has been obtained with patient in sitting semi-upright position. analysis is performed in direct comparison with the next preceding similar study of <unk>. marked cardiac enlargement unchanged. unchanged position of previously described left-sided permanent pacer with dual intracavitary electrode system. the pulmonary congestive pattern persists and may even have increased. the lateral pleural sinuses are only mildly blunted but it is likely that the pleural effusions are layering posteriorly as the patient is in marked recumbent position. no pneumothorax identified.
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<unk>-year-old female patient with increasing oxygen requirements, evaluate volume status.
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the new og tube terminates in the upper stomach and would need to be advanced approximately <num> cm to position all of the sideholes in the stomach. lungs are hyperinflated, but clear without effusion or consolidation. heart, mediastinum, hila, and pleural surfaces are normal. old healed left rib fractures are unchanged. the endotracheal tube terminates <num> cm above the carina and should not be withdrawn any further. the caliber of the endotracheal et cuff exceeds that of the native trachea.
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<unk> year old man with l hip orif, post op s/p og placement. og placement.
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single portable view of the chest. right-sided central venous line is seen with catheter tip in the mid svc. there is no visualized pneumothorax. relatively low lung volumes are seen. there is crowding of the bronchovascular markings with possible mild pulmonary edema. cardiomediastinal silhouette is within normal limits given patient positioning and rotation to the left. atherosclerotic calcifications are noted. median sternotomy wires and mediastinal clips as well as repair changes are seen. no acute osseous abnormality is identified.
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<unk>-year-old male with sepsis and bandemia. central venous line placement.
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pa and lateral views of the chest were obtained. heart is normal size, and cardiomediastinal silhouette is unchanged. lung volumes have increased, however, right infrahilar opacities persist. there is no pleural effusion or pneumothorax.
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<unk>-year-old man with equivocal findings on previous chest radiograph and leukocytosis, rule out pneumonia.
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frontal and lateral chest radiographs demonstrate clear well expanded lungs. there is interval improvement in pulmonary vascular congestion. there is no pleural effusion, or pneumothorax. the cardiac silhouette remains moderately enlarged. the mediastinal contours are notable for aortic tortuosity and prominent contours of the pulmonary arteries.
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<unk>-year-old female with abdominal pain. evaluate for infection.
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moderate cardiomegaly is increased compared to the previous chest radiograph, partially accentuated by slightly low lung volumes. the aorta remains tortuous. there is minimal pulmonary vascular congestion without overt pulmonary edema. subsegmental atelectasis is seen within the right middle and lower lobes. no focal consolidation, pleural effusion or pneumothorax is present. there are no acute osseous abnormalities.
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history: <unk>f with dyspnea, orthopnea worse in the past months. crackles bibasilar
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lungs relatively hyperinflated. no focal consolidation is seen. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are stable.
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history: <unk>f with lightheadedness. h/o <unk>. dry cough // ?pna
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pa and lateral views of chest. the heart, mediastinum, hilar contours, pleural surfaces and lungs are all normal.
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chest pain
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multiple ekg leads overlie the right lower chest. allowing for this, i doubt significant interval change. again seen is upper zone redistribution, without overt chf. also again seen is patchy opacity in the right cardiophrenic region which could represent either focal atelectasis or a pneumonic infiltrate. the appearance is not significantly changed compared with <unk> or <unk>. subsegmental atelectasis left lung base has increased. minimal blunting the right costophrenic angle is unchanged. the left costophrenic sulcus is clear.
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<unk> year old man with chf and worsening dyspnea // evaluate for infiltrate or worsening edema
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the right upper lobe opacity has progressed since <unk> and <unk>. there is a new left upper lobe diffuse opacity, also involving the middle and lower lung zones to a lesser degree, concerning for infection. there is severe emphysema. there is no pleural effusion or pneumothorax. cardiomediastinal silhouette is normal.
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<unk>-year-old man with fever, please evaluate for pneumonia.
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compared with the immediate prior study of <unk>, vascular engorgement of the mediastinum has significantly improved. pulmonary vascular congestion has decreased, and pulmonary edema is improved, now mild. moderate bilateral layering pleural effusions are unchanged. there is no focal consolidation or pneumothorax. cardiomegaly has improved, now mild.
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<unk> year old woman with fluid overload // please assess for interval changes
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single upright portable view of the chest demonstrates slightly low lung volumes, with linear bands of atelectasis in the left lung base and at least a small left effusion. otherwise, the cardiomediastinal silhouette is unremarkable. there is no large right pleural effusion, pneumothorax, or overt pulmonary edema.
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<unk>-year-old male with chest pain.
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pa and lateral views of the chest provided. chronic scarring at the left lung base is essentially stable from prior ct abdomen pelvis from <unk>. upper lobe lucency with hyperinflated lungs suggests underlying emphysema. no focal consolidation to suggest pneumonia. no definite effusion or pneumothorax. the cardiomediastinal silhouette appear stable. evidence of prior left seventh rib resection noted. no acute bony injuries.
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<unk>f w/ h/o bronchiectasis with r sided chest pain // ? intrapulmonary process
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the lungs are clear without consolidation or edema. there is no pleural effusion or pneumothorax. the mediastinal contours are normal. the heart size is slightly increased from prior exam, but remains at the upper limits of normal.
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chest pain and palpitations. evaluate for pneumonia.
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right-sided port-a-cath tip terminates in the low svc. no pneumothorax. cardiac, mediastinal and hilar contours are normal. lungs are clear. no pleural effusion or pneumothorax is present. no acute osseous abnormality is visualized.
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history: <unk>f with of dvt and now chest pain. status post port placement
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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. streaky left basilar opacities suggest minor atelectasis or scarring. the lungs appear otherwise clear. bony structures are unremarkable.
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chest pain and dyspnea.
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a left-sided port-a-cath catheter remains in unchanged position, likely terminating at the cavoatrial junction. a right sided pleural effusion is unchanged. there is bibasilar atelectasis. there is no pneumothorax. the cardiomediastinal and hilar contours are stable.
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shortness of breath. evaluate for pneumonia.
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pa and lateral views of the chest. the lungs are hyperinflated but clear consolidation or effusion. cardiomediastinal silhouette is within normal limits. there is no free air below the diaphragm. osseous and soft tissue structures are unremarkable.
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<unk>-year-old male status post hemorrhoidectomy with abdominal distention and pain.
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frontal and lateral views of the chest were obtained. the heart is of normal size with normal cardiomediastinal contours. linear opacity in the right lower lung is compatible with atelectasis. otherwise no focal consolidation or diffuse abnormality. no pleural effusion or pneumothorax. the osseous structures are unremarkable. no radiopaque foreign bodies.
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<unk>-year-old female with weakness, cough, and green sputum. rule out infiltrate.
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cardiac silhouette size is normal. the aorta is mildly tortuous. mediastinal and hilar contours are otherwise unchanged. the pulmonary vascularity is normal. lungs are clear without focal consolidation. blunting of the left costophrenic angle posteriorly is chronic, likely reflecting mild pleural thickening. no pleural effusion or pneumothorax is detected. there are mild degenerative changes in the thoracic spine.
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mild cough and altered mental status.
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since <unk>, there has been interval improvement in increased interstitial markings bilaterally with prominence of the interstitial markings remaining, but to a lesser degree, may be due to very gradually improving process, as suggests an on prior chest ct from <unk> ; possibly very gradually improving infectious with possible underlying cryptogenic organizing pneumonia. however, since the prior ct from <unk>, today there appears to be increased blunting of the right costophrenic angle raising concern for a small right pleural effusion and possible pleural thickening. no left pleural effusion is seen. there is no evidence of pneumothorax. cardiac and mediastinal silhouettes are stable.
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history: <unk>m with hypoxia, vomiting // p
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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 are hyperinflated as suggested by flattening of the hemidiaphragms. the lungs appear clear. small osteophytes are similar along the upper to mid thoracic spine.
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chest pain and dyspnea.
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the lung volumes are low, limiting evaluation and accentuating the bronchovascular structures. within the limitations, there is no focal opacity, pulmonary edema, pleural effusion, or pneumothorax. the mediastinal contours are normal. the heart size is moderately enlarged, and unchanged from the prior exam.
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headache and vision loss. evaluate for pneumonia.
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the heart is mild to moderately enlarged. there is mild interstitial abnormality including mild cephalization of pulmonary vascularity suggesting slight vascular congestion. more focal patchy opacity obscures the cardiac borders and left hemidiaphragm in the left lower lung. it is difficult to exclude small pleural effusions. there is no pneumothorax.
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tachycardia.
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no focal consolidation, pleural effusion or pneumothorax. the size of the cardiomediastinal silhouette is within normal limits.
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<unk> year old woman with cirrhosis here for bleeding ulcer now with sudden onset <unk> chest pain radiation to left and back chest. // eval for ptx, widened mediastinum, other etiology for chest pain
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upright ap and lateral views of the chest provided. midline sternotomy wires and mediastinal clips are again noted. the lung volumes are low with no convincing sign of pneumonia or chf. no large effusion or pneumothorax. the heart size is top-normal. mediastinal contour is unremarkable. bony structures are intact.
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<unk>m with malaise // infiltrate?
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an endotracheal tube terminates <num> cm above the carina. an orogastric tube extends at least to the stomach. a right ij catheter terminates at the mid svc. a left cardiac pacemaker projects a lead into the right atrium, however the defibrillation and ventricular pacer wires deviate at the level of the tricuspid valve, the latter possibly taking a left ventricular course. there is no pneumothorax or pleural effusion. numerous predominantly right-sided nodular opacities are minimally changed since the prior two chest radiographs performed on the same day.
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pneumonia.
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a large hiatal hernia is again noted. the lungs are clear. the heart and mediastinum are stable in appearance. there is no pleural effusion or pneumothorax.
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history: <unk>f with s/p fall, generalized weakness // eval for trauma
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there are bibasilar opacities and blunting the lateral costophrenic angles. the lungs superiorly are clear of consolidation of there is somewhat indistinct pulmonary vascular markings. cardiac silhouette is enlarged but likely in part accentuated by portable technique. no acute osseous abnormalities.
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<unk>m with dyspnea // evidence of effusion or pneumonia
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a tracheostomy tube appears properly positioned though partially obscured by the patient's o<num> mask. there is no pneumothorax, focal consolidation, or pleural effusion. mild bibasilar atelectasis is exaggerated by low lung volumes.
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copd, post revision of tracheostomy.
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heart size and cardiomediastinal contours are normal. lung volumes are low but the lungs are clear without focal consolidation, pleural effusion, or pneumothorax. leads of a left chest wall pacer terminate in stable position.
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<unk>m with acute worsening of chronic weakness // infection?
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the lungs are hyperinflated with flattened hemidiaphragms, compatible with copd. a trace right pleural effusion is new from <unk>. there is no focal consolidation concerning for pneumonia. no pneumothorax is seen. the cardiac silhouette remains enlarged but stable. the mediastinal and hilar contours are within normal limits.
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cough and fever.
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slightly rotated positioning. the picc line tip is poorly delineated, but appears to overlie the mid svc. no pneumothorax is detected. a left-sided single lead pacemaker is in place, with lead tip over the right ventricle. there is stenting of the aorta. the patient is status post sternotomy, with a prosthetic valve. the heart is not enlarged. mild prominence of the main pulmonary artery may be present, but is unchanged. there is upper zone redistribution, without other evidence of chf. no focal infiltrate or gross effusion. minimal bibasilar atelectasis. the extreme left costophrenic angle is excluded from the film.
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<unk>-year-old man with history of as s/p bovine avr, hfpef (ef <unk>%), afib, niddm, and recent right total hip replacement complicated by infection. will be deced tommorow with picc - abx till <unk>. picc out <num> cm today // confirm placement picc
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the lungs are clear without consolidation or edema. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal. no fracture is identified.
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status post mechanical fall.
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there is acute consolidation of left lower lobe which could be due to atelectasis but pneumonia cannot be ruled out. there is bilateral small to moderate pleural effusions. moderate to severe cardiomegaly is unchanged. hiatal hernia is again noted.
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<unk> year old woman with dchf, pulmonary hypertension, dyspnea. // please assess for edema, interval change.
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right convex thoracic scoliosis is re- demonstrated along with sternal suture wires and mediastinal clips, consistent with prior cabg. mild cardiac enlargement with prominence of the apex, is unchanged. there is diffuse prominence of the pulmonary interstitial markings, but no focal consolidation is appreciated and there is no pleural effusion or pneumothorax. osseous structures appear unchanged.
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history: <unk>f with cough, short of breath // ? pneumonia
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left basilar opacities may reflect atelectasis and/or consolidation. no pleural effusion or pneumothorax identified. the size the cardiomediastinal silhouette is within normal limits.
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<unk> year old man with c<num>/c<num> fractures, hx multiple system atrophy, increased o<num> requirement // eval for pna, consolidation
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ap portable supine view of the chest. there has been interval intubation with the tip of the endotracheal tube residing approximately <num> cm above the carina. left chest wall pacer device is unchanged with prosthetic cardiac valve in midline sternotomy wires again noted. patient is slightly leftward rotated. right cp angle is excluded. the heart remains moderately enlarged. the lungs remain mostly clear and hyperinflated.
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<unk>m with s/p intubation // tube placement
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the lungs are clear without focal consolidation, effusion, or edema. hazy opacity at the right cardiophrenic angle is compatible with prominent fat pad seen on ct scan. azygos fissure is incidentally noted. cardiac silhouette is within normal limits. no acute osseous abnormalities. hypertrophic changes are noted in the spine.
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<unk>m with viral vs. bacterial infection.// pneumonia
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a single frontal portable radiograph of the chest was acquired. the endotracheal tube is appropriately positioned, ending <num> cm above the level of the carina. an enteric catheter courses below the level of the diaphragm and out of the field of view inferiorly. there is a right internal jugular central venous catheter ending in the mid-to-low svc. there is redemonstration of complete opacification of the left hemithorax with rightward displacement of the mediastinal structures, not significantly changed. there is minimal right lower lung atelectasis. the heart size cannot be assessed on this radiograph but was seen to be normal on the outside hospital ct dated <unk>. there is no definite pneumothorax. no right pleural effusion is seen.
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evaluate endotracheal tube position.
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there is no focal consolidation, pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal. there are no displaced fractures.
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<unk> year old man with recent pneumonia // confirm resolution
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there no focal consolidation, pleural effusions or pneumothoraces. the heart is top-normal in size, and mediastinal contours are stable.
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<unk> year old woman with fever and productive cough, lung exam wnl. // ? pna
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there is no significant change compared to prior examination with redemonstration of scattered asymmetric right greater than left opacities compatible with multifocal pneumonia. there is a probable small left pleural effusion. there is no pneumothorax. an ng tube remains in appropriate position. a right-sided picc line terminates in the mid svc.
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hypoxia, tachycardia. question worsening pneumonia, effusion, or pneumothorax.
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retrocardiac opacity is poorly seen on this single view but could reflect atelectasis or developing infectious process. lungs are somewhat low in volume giving the appearance of vascular crowding, though mild pulmonary vascular congestion is present as well. mild right base atelectasis is noted, early infection not excluded in the appropriate clinical setting. cardiac size is moderately enlarged with changes of prior coronary bypass graft noted. no pneumothorax or pleural effusion is seen.
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copd with dyspnea.
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the lungs are grossly clear without focal consolidation, pleural effusion, or pneumothorax. a large hiatal hernia is again seen with mild adjacent atelectasis. surgical clips project over the right upper abdomen. degenerative changes of the thoracic spine are moderate.
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<unk>m with weakness, cough. evaluate for pneumonia.
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the inspiratory lung volumes are appropriate. the lungs are clear without pleural effusion, consolidation or pneumothorax. the pulmonary vasculature is not engorged. the cardiac silhouette is normal in size. mediastinal and hilar contours are within normal limits. a gas bubble in the right upper quadrant of the abdomen may indicate colonic interposition, but is not clearly visualized as such on the corresponding lateral radiograph.
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<unk>-year-old female with history of sarcoid and family history of thoracic aortic aneurysm, here to evaluate for pulmonary sarcoid or abnormal thoracic aorta.
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dobhoff tube in situ in the proximal to mid stomach. left-sided picc line in situ with the tip in the proximal svc. no left-sided pneumothorax. decreased lung volumes. bibasal pleural effusions with associated atelectasis appear similar to slightly increased compared to previous imaging. no pulmonary edema. the heart size appears normal. unfolding of the thoracic aorta are with associated atherosclerotic calcifications.
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<unk> year old man with pulmonary edema // f/u x-ray
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et tube is present with tip approximately <num> cm from the carina. ng tube courses below the diaphragm into the stomach. mild pulmonary edema is noted. there are bilateral patchy opacities, more prominent at the lung bases which may reflect atelectasis, however, infectious process cannot be excluded. small left pleural effusion may be present. no pneumothorax. cardiomediastinal silhouette is unremarkable. right humeral head appears slightly inferiorly subluxed.
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<unk>-year-old female with question sepsis, intubated, question tube placement.
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there is new indistinctness of the pulmonary vasculature consistent with pulmonary vascular congestion with no evidence of pulmonary edema. there is no change in mild cardiomegaly. no pleural effusion or pneumothorax is present. no focal consolidation is present.
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hypertension and pedal edema, complains of dyspnea on exertion. rule out pulmonary edema.
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ap portable upright and lateral view the chest provided. lung volumes are low. kyphotic angulation of the chest somewhat limits the evaluation through the lower lungs. allowing for this, the lungs appear clear. heart appears mildly enlarged as on prior. mediastinal contour is unremarkable. no large effusion or pneumothorax. imaged osseous structures are intact. no free air seen below the right hemidiaphragm.
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<unk>f with a history <unk> <unk>'s disease presents with questionable fall and head strike <num> month ago. evaluate for pneumonia.
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cardiomediastinal silhouette is normal. there is no pleural effusion or pneumothorax. there is no focal lung consolidation. calcified left hilar and adjacent mediastinal and cervicothoracic lymph nodes, demonstrated on prior abdominal ct from <unk>, indicate prior granulomatous infection, including tuberculosis or histoplasmosis.
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<unk>-year-old woman with elevated lfts, concern for occult infection, evaluate for pneumonia
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lung volumes are low. there may be mild, central pulmonary vascular congestion. the cardiac silhouette is stably enlarged. again noted are aortic arch calcifications. there appears to be an opacity in the retrocardiac region. evaluation of the lateral film is limited due to patient positioning and poor inspiratory effort. possible small right pleural effusion is present. there is no pneumothorax.
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history: <unk>f with cough, hypotension // pna?
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an endotracheal tube terminates at the thoracic inlet in standard placement. lung volumes are low, but the lungs are grossly clear. there is no pneumothorax. old healed bilateral rib fractures are unchanged. the heart and mediastinum are magnified by the projection.
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<unk> year old man with gi bleed s/p et tube placement // et tube placement
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ap portable upright view of the chest. overlying ekg leads are present. there is suture material projecting over the right upper lung as on prior. lungs are hyperinflated and somewhat lucent which may reflect emphysema. linear density in the right lower lung abutting the diaphragm is likely atelectasis or scarring. there is no focal consolidation, large effusion or pneumothorax. there is a severe dextroscoliosis of the t-spine. partially imaged vertebroplasty changes in the mid lumbar spine noted. cardiomediastinal silhouette is grossly within normal limits.
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<unk>f with sob
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the lungs are well-expanded, with minimal atelectasis or scarring in the right lung base. there is no pleural effusion comp pulmonary edema, pneumothorax, or focal airspace consolidation. irregularity of the posterior eighth rib is again seen, unchanged since the prior study.
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history: <unk>m with r-chest wall pain after assault <num> week ago, subjective chills // evaluate for pneumonia, pulmonary contusion, rib fractures
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left-sided aicd /pacemaker seen device is noted with leads terminating in right atrium and right ventricle. cardiac silhouette size is mildly enlarged with a left ventricular predominance. the aorta is tortuous and demonstrates diffuse atherosclerotic calcifications. lung volumes are low. pulmonary vascularity is within normal limits without evidence of pulmonary edema. no focal consolidation, pleural effusion or pneumothorax is present. widening of the right paratracheal stripe is likely related to low lung volumes. there are no acute osseous abnormalities. mild deformity of the mid shaft of the left clavicle may suggest a remote healed fracture. no free air is noted under the diaphragms.
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vomiting and hypotension.
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cardiomediastinal and hilar contours are stable. there is persistent elevation of the right hemidiaphragm. there is no pleural effusion or pneumothorax. the lungs are well expanded and clear. pulmonary vasculature is within normal limits.
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chronic cough with tobacco use.
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pa and lateral views of the chest. the lungs are hyperinflated, consistent with emphysema. the lungs are otherwise clear. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is unremarkable. a tortuous aorta is again noted.
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chest pain, patient homeless, concerning for pneumonia.
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pa and lateral views of the chest provided. lateral view is limited due to obliquity. lungs are clear. no pleural effusion or pneumothorax. heart and mediastinal contours are normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
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<unk>m with cough fever // pna
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heart size is normal. mediastinal and hilar contours are unchanged. mild prominence of the pulmonary vascular markings is unchanged, without overt pulmonary edema. new ill-defined nodular opacities are seen within the right lung, the largest measuring <num> mm and located within the right lung base. minimal patchy opacities in the lung bases likely reflect atelectasis. no pleural effusion or pneumothorax is identified. no acute osseous abnormality is present. an electronic device is noted within the left mid anterior wall.
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history: <unk>m with syncope
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frontal and lateral views of the chest were obtained. lung volumes are low, exaggerated bronchovascular markings, which are minimally prominent. no focal consolidation, pleural effusion, or pneumothorax. the heart size and cardiomediastinal contours are normal. anterior cervical disc fusion construct is incompletely imaged.
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<unk>-year-old male with large legs. evaluate for volume overload.
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enteric tube passes into the stomach and out of view. et tube ends <num> cm from the carina. cardiomegaly is stable. there is mild pulmonary edema, slightly decreased from prior study. no pleural effusion or pneumothorax. no focal consolidation. mediastinal and hilar contours are unchanged.
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history: <unk>f with altered mental status // post-intubation film
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heart size is normal. cardiomediastinal silhouette and hilar contours are normal. lungs are clear. pleural surfaces are clear without effusion or pneumothorax. thoracic cage is grossly intact without obvious fracture.
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left-sided chest pain.
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a left-sided picc line terminates in the mid svc. lung volumes are low which causes vascular crowding as well as bibasilar atelectasis. an exaggeration of the cardiac size. no pleural effusion, pneumothorax or focal consolidation worrisome for pneumonia. ng tube terminates in the duodenum.
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new picc line.
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mild cardiomegaly is stable. the mediastinal and hilar contours are normal. mild prominence of the central vasculature is similar to <unk>. there is some cephalization of vessels. right lower lobe opacity is new and right atrium is enlarged compared to <unk>. no pleural effusion or pneumothorax.
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<unk> year old woman with known copd, bronchitis, worsening cough now with pink tinged sputum.
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portable semi-upright radiograph of the chest demonstrates hyperinflated, clear lungs. cardiomediastinal and hilar contours are unchanged. there is slight elevation of the left hemidiaphragm. there is no pneumothorax, consolidation, or pleural effusion.
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history: <unk>m with chest pain // eval for ptx, pna
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rotated chest radiograph. the right hilar mass is barely apparent on the chest radiograph. the heart size is normal. no airspace consolidation. no pulmonary edema. no pleural effusions. no pneumothorax.
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<unk> year old woman with hx of breast cancer found to have new hilar mass and now hypotensive // eval etiology of hypotension
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endotracheal tube terminates <num> cm above the carina. ng tube terminates below the diaphragm. pacer leads terminate in the right atrium and right ventricle. aortic valve replacement appears in appropriate position. there is widespread heterogeneous hazy opacification of the right lung. no substantial pleural effusion or pneumothorax.
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history: <unk>f intubated // acute process?
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compared with <unk> at <time>, the et tube, ng tube and left ij central line have been removed. the right pigtail has also been removed. minimal blunting of the right costophrenic angle is very slightly greater. no pneumothorax or other evidence of right-sided effusion is identified. allowing for technical differences, there is otherwise minimal interval change. again seen is focal sclerosis in the right proximal humerus. is there history of old healed fracture. no lucent fracture line is identified.
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<unk> year old woman with hemoptysis, known pe, chest tightness // ?interval change
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pa and lateral views of the chest. the lungs are clear. cardiac silhouette is normal in size. hilar and mediastinal contours are normal. no pleural effusion. no evidence of pneumothorax.
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right-sided pleuritic chest pain.
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indistinct pulmonary vascular markings are seen. there are bibasilar left-greater-than-right and left perihilar patchy regions of consolidation. external respiratory device overlies the left upper lung. there is no large effusion. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
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<unk>f with chf // ? pna
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lung volumes are low, and the lungs are clear of focal consolidation, pleural effusion or pneumothorax. the heart size is normal. the mediastinal contours are normal. no displaced rib fractures are seen. vertebral body height loss in the mid-lower thoracic spine is again noted, and degenerative changes are seen in the right shoulder.
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<unk>-year-old the mild presents after fall. evaluate for fracture.
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compared with <unk>, i doubt significant interval change. again seen is moderate cardiomegaly, with a calcified aorta. there is upper zone redistribution, without other evidence of chf. no focal infiltrate or effusion is detected. possible minimal atelectasis at the right lung base laterally.
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<unk>f pmhx for multiple vascular interventions admitted for hep gtt in preparation for her scheduled aorto bi femoral bypass graft. // pre-op
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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 evidence of subdiaphragmatic free air. the visualized osseous structures are unremarkable. there is no pleural effusion or pneumothorax.
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history of worsening abdominal pain and chest pain. please evaluate.
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heart size is normal. the aorta is tortuous with prominence of the ascending aortic contour. pulmonary vasculature is normal. streaky opacities in the lung bases likely reflect areas of atelectasis. no pleural effusion or pneumothorax is seen. nasogastric tube tip is within the stomach. several clips are noted in the right upper quadrant of the abdomen compatible with prior cholecystectomy. spiral tacks overlying the midline upper abdomen are compatible prior ventral hernia repair. unchanged posttraumatic deformity of the left fourth rib is again seen.
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history: <unk>f with small bowel obstruction status post nasogastric tube placement
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the heart is mildly enlarged, and there is mild central pulmonary vascular congestion. no focal consolidation, pleural effusion or pneumothorax is seen. prior right rotator cuff surgery is noted.
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<unk>-year-old male with confusion.
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no focal consolidation, edema, effusion, or pneumothorax. the heart remains top-normal in size. the mediastinum is not widened. the stomach is distended with ingested contents. no evidence of fracture on this nondedicated exam. a right all subclavian approach central venous catheter has been removed in the interim.
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<unk>-year-old woman presenting with chest pain. evaluate for pneumonia.
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lower lung volumes seen on the current exam with bibasilar atelectasis. the lungs are otherwise clear. there is no effusion or pneumothorax. cardiomediastinal silhouette is within normal limits. atherosclerotic calcifications are noted at the aortic arch. thoracolumbar s-shaped scoliosis is noted.
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<unk>f w/chest pain
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frontal supine portable radiograph of the chest demonstrates mild enlargement of the cardiac silhouette which is stable given differences in technique. bibasilar atelectasis. no focal consolidation, pleural effusion or pneumothorax.
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follow and chest pain. evaluate for pneumothorax.
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left-sided central venous catheter with tip projecting over the right atrium is similar compared to prior. the lungs are clear without focal consolidation, effusion, or edema. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities. rounded calcific density in the right upper quadrant is unchanged.
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<unk>m with chest pain r/o pna
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the lungs are clear, the cardiomediastinal silhouette and hila are normal. there is no pleural effusion and no pneumothorax.
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<unk>-year-old with cough.
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there may be mild unchanged cardiomegaly. retrocardiac opacity likely reflects basilar atelectasis. bibasilar interstitial abnormality was better characterized on prior ct chest from <unk>. otherwise, the lungs are clear without new focal consolidation. there is no pneumothorax. there is no pleural effusion. minimal angulation of a left lateral rib, likely the seventh rib, is noted without a discrete fracture line.
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<unk> year female with epigastric pain following a motor vehicle accident, evaluate for free air or rib fractures.
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the endotracheal tube terminates at the level of the carina and should be withdrawn <num> cm for standard positioning. bilateral chest tubes, mediastinal drains and an enteric tube are well positioned. a left paramedian drain is sharply angulated and should be revised if poorly functioning. sternotomy wires are constant. retrocardiac atelectasis is unchanged. there is no pneumothorax. pleural effusions, if there were any before, have resolved. the cardiac silhouette is smaller in size and pulmonary edema has resolved after pericardial window formation. postoperative appearance of the mediastinum is unchanged from yesterday.
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status post pericardial window.
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the left apical pneumothorax has increased in size compared to prior study. compressive atelectasis on the left and basilar atelectasis on the right have also increased. mild vascular congestion is unchanged. no other changes compared to prior exam.
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<unk> year old man s/p ct removal // r/o ptx
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evaluation somewhat limited by patient rotation. endotracheal tube <num> cm above the carina. left internal jugular approach central venous catheter terminates in the upper svc just distal to the brachiocephalic confluence. fluid layering in the right minor fissure with some adjacent patchy opacity likely reflecting atelectasis. lungs otherwise clear. no pneumothorax or pulmonary edema.
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status post central venous catheter placement.
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the lungs are clear without focal consolidation. there is a focal opacity in the retrosternal clear space on the lateral view which is unchanged dating back to <unk>. there is no effusion or vascular congestion. the cardiomediastinal silhouette is stable. no acute osseous abnormalities.
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<unk>m with productive cough // pneumonia
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the lungs are well expanded and clear. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is unremarkable.
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history: <unk>m with chest pain // ? pna
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there is left basilar atelectasis. the lungs are otherwise clear without focal consolidation. cardiomediastinal silhouette is normal. no pleural effusion or pneumothorax is present. there is no evidence of pulmonary vascular congestion.
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cough and fever for <num> days, wheezing and decreased breath sounds at right mid and lower lung. exclude pneumonia.
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ap and lateral chest radiographs were obtained. the lungs are well expanded and clear. there is no focal consolidation, effusion, or pneumothorax. a large upper mediastinal mass, stable in size, continues to cause leftward deviation of the trachea. the aorta is mildly tortuous. there are no other abnormal cardiac or mediastinal contours.
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shortness of breath.
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the dobbhoff tube has been partially removed and its tip is just below the gastroesophageal junction. surgical <unk> from exploratory laparotomy are redemonstrated. otherwise, lung volumes are low. linear opacities across the left lower lobe represent segmental atelectasis. there is also some retrocardiac atelectasis obscuring the margin of the left hemidiaphragm. no other focal opacities are present. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax. although assessment of abdominal free air cannot be performed due to poor position, no secondary signs of free air are identified.
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<unk>-year-old man status post stab wound to the abdomen status post exploratory laparotomy and new placement of dobbhoff tube. evaluate for evidence of perforation.
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frontal and lateral views of the chest are compared to previous exam, chest x-ray from <unk>, and ct of the abdomen and pelvis performed earlier the same day. blunting of the left costophrenic angle is likely due to a combination of atelectasis or scar and left cardiophrenic fat pad seen on ct. increased density projecting over the spine inferiorly is compatible with left basilar bronchiectasis and scarring identified on ct. there is no new consolidation. cardiomediastinal silhouette is within normal limits. median sternotomy wires are again seen.
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<unk>-year-old male with leukocytosis.
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lung volumes have improved. the left picc tip projects in the expected region of the svc-ra junction, unchanged. no focal consolidation, edema, effusion, or pneumothorax. the heart normal in size. mediastinal contours are unchanged.
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<unk> year old woman with fever. evaluate for infiltrate.
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a right-sided cardiac pacemaker projecting leads into the right atrium and ventricle, right ij catheter terminating at the cavoatrial junction, and the kyphoplasty cement are unchanged in configuration and positioning since the <unk> examination. mild cardiomegaly with central pulmonary vascular congestion and pulmonary edema is stable. a left retrocardiac opacity, likely reflecting atelectasis, is unchanged. small bilateral pleural effusions are stable. there is no pneumothorax.
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sudden dyspnea.
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moderate cardiomegaly is unchanged. the aicd is unchanged extending into the right ventricle. no focal consolidation, large effusion or pneumothorax is seen. there is mild central hilar engorgement without frank pulmonary edema. bony structures appear intact.
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<unk>-year-old man with hypoxia and dyspnea. evaluate for pulmonary edema.
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there are relatively low lung volumes. medial right base opacity could be due to atelectasis however consolidation is not excluded in the appropriate clinical setting. no pleural effusion is seen. the cardiac and mediastinal silhouettes are stable. there is no pulmonary edema. no evidence of pneumothorax is seen.
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history: <unk>f with confusion // r/o pna
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cardiac silhouette size is normal. the aorta demonstrates diffuse atherosclerotic calcifications and mild tortuosity. the patient is status post esophagectomy and gastric pull-through with similar appearance of the mediastinal and hilar contours. fiducial marker is noted within a right apical lesion with surrounding opacity compatible with post treatment changes, better assessed on the prior ct and grossly unchanged. lungs remain hyperinflated without new focal consolidation, pleural effusion or pneumothorax identified. hypertrophic changes are noted in the thoracic spine. post thoracotomy changes of the right rib cage are again noted along with remote left-sided rib fractures.
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history: <unk>m with failure to thrive, endorses paroxysmal dyspnea, history of lung/esophageal cancer
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frontal and lateral radiographs of the chest were acquired. the lungs are clear aside from minimal left lower lobe atelectasis. the heart size is normal. the descending thoracic aorta is mildly tortuous. aortic calcifications are noted. there are no pleural effusions. no pneumothorax is seen. multilevel degenerative changes of the thoracolumbar spine are again noted.
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dementia with worsening agitation. assess for pneumonia.
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the lungs are clear. the cardiac and mediastinal contours are normal. there are no pleural effusions. no pneumothorax is seen. s-shaped scoliosis of the thoracolumbar spine is noted.
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cough. evaluate for infiltrate.
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lung volumes are slightly low. no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. heart and mediastinal contours are within normal limits. no acute fracture is detected on these views.
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<unk>-year-old male with left rib pain, status post bicycle accident.
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