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the medial aspect of the lung apices is not well visualized due to patient positioning. lungs are otherwise clear of consolidation, sizeable pleural effusion or pneumothorax. heart size is normal. no acute osseous abnormalities identified. marked gaseous distension of the stomach is incidentally noted, with elevation of the left hemidiaphragm.
<unk>-year-old female with weakness
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there is a large hiatal hernia with adjacent atelectasis. bibasilar opacities likely represent combination of the above, without clear focal consolidation. no large pleural effusion or pneumothorax is seen. the aorta is calcified and tortuous. cardiac silhouette size is mildly enlarged. no overt pulmonary edema is seen.
history: <unk>f with afib // acute cardiopulmonary abnormality? pna? fluid?
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the visualized lung fields are clear of any focal opacities, pleural effusions or pneumothorax. lung markings in the retrocardiac space are likely atelectasis within the left lower lobe. the cardiac and mediastinal silhouette is unremarkable. visualized osseous structures are unremarkable.
history of hypertension, hyperlipidemia, stage i breast cancer, presenting with cough and weakness. evaluate for pulmonary infiltrates.
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the lungs are hyperinflated. there is a focal opacity overlying the right lower lobe, which may be representative of a developing pneumonia in the proper clinical setting. there is also a small right pleural effusion. otherwise, the remainder of the lungs are clear. the heart is severely enlarged, slightly increased in comparison to prior studies. the aorta appears large and tortuous, with calcifications, not significantly changed in comparison to prior study. diffuse osteopenia of the thoracic spine is again noted. decreased loss of height of multiple vertebral bodies as previously, stable.
copd with worsening shortness of breath.
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there has been interval partial clearing of the alveolar infiltrates in the lower lobes. however there continue to be residual patchy areas of alveolar infiltrate lower greater than upper lobe with ill-defined vasculature and mild cardiomegaly.. there is a small right effucstion.
acute on chronic heart failure.
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a trauma board limits evaluation of these radiographs. lung volumes are low, causing exaggeration of the heart size and accentuation of the pulmonary vasculature. the lungs are clear. there is no definite pneumothorax. no pleural effusions are seen. the heart is normal in size. mediastinal contours are normal. there is elevation of the right hemidiaphragm, of unknown chronicity. no definite free air is seen within the abdomen on the supine radiograph.
stab injury to the left flank. evaluate for pneumothorax or pneumoperitoneum.
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the lungs are clear. the hilar and cardiomediastinal contours are normal. minimal elevation of the left hemidiaphragm is chronic. there is no pneumothorax. there is no pleural effusion. pulmonary vascularity is normal.
<unk>-year-old man with a history of anxiety presents with chest pain.
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the lungs are well expanded and clear. hila and cardiomediastinal contours and pleural surfaces are normal. right aortic arch again noted.
<unk>m with chest pain // eval for ptx, pna
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since prior, right-sided central venous catheter is has been placed. tip projects over the lower svc. there is no right sided pneumothorax. otherwise, there has been no change. there is a right sided pleural thickening unchanged from prior.
<unk>m with s/p r ij // eval for line placement
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since <unk>, the right lung has new opacifications in the mid to lower lung field with increased basilar atelectasis, concerning for pleural effusion. left retrocardiac and basilar atelectasis is increased. bilateral atelectasis. unchanged moderate to severe cardiomegaly. positioning of temporary pacemaker wire is seen in the rv. the tip of an endotracheal tube is seen <num> cm above the carina. no pneumothorax.
<unk> year old woman w/ anemia s/p pea arrest. // interval change
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the heart and great vessels are normal. the lungs are clear of an active process and well expanded. there is no pleural effusion or pneumothorax.
<unk>f w/ h/a and elevated wbc count. // concern for intapulmonary source of elevated wbc
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ap upright and lateral views the chest. fusion hardware is seen spanning the cervicothoracic junction. the patient's chin partially obscures the superior mediastinum limiting assessment. there is a linear density in the left lower lung which is most compatible with scarring. no convincing evidence for pneumonia or edema. no large effusion or pneumothorax. the cardiomediastinal silhouette is stable. patient is slightly rotated to her right limiting assessment. no acute osseous abnormality is detected.
<unk>f with generalized weakness // eval for acute process
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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.
<unk>m with <unk>d l sided chest pain, cough occasional productive of yellow sputum // eval for consolidation/cardiomegaly
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low lung volumes. interval increase in bilateral hilar and perihilar vasculature as well as right paracardiac opacity. persistent left retrocardiac and left basilar opacities. stable cardiomegaly. likely small bilateral pleural effusions. an enteric tube is again identified coursing below the diaphragm, tip not visualized. ekg leads overlie the chest wall.
<unk>m s/p pancreatic debridement <unk> with wheezing and cough overnight // please assess for pulmonary pathology
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when compared to previous exam, there has been no significant interval change. elevation the right hemidiaphragm is again noted. blunting of the right lateral costophrenic angle could be due to pleural based scarring. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with fever, hx of mrsa septic emboli <unk> endocarditis // pna?
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lung volumes are normal. there is no focal consolidation, effusion, or pneumothorax. mediastinal and hilar contours are normal. heart size is normal. there is mild anterior height loss of likely the t<num> vertebral body which is age indeterminate could be chronic. on the ap view, there is a lucency in the region of the left scapular spine.
<unk>f with s/p accident with shoulder, arm pain // ? traumatic injury
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lung volumes are slightly low. no focal areas of consolidation are identified to suggest the presence of pneumonia. . no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
<unk> year old man with myalgias and fevers // ?infection
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lung volume is low. small left pleural effusion is similar to <unk>. cardiac silhouette and pulmonary vasculature is exaggerated by low lung volumes. there is no focal consolidation. known rib fractures seen on prior ct is not visualized on this radiograph.
history: <unk>m with chest pain // ? worsening l effusion
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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.
<unk>f with chest pain and palpitations // eval for chf/pneumonia
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mild atelectasis is seen in the lower lung bases with possible small residual scarring in the left lower lung. no pneumonia, pulmonary edema, or pneumothorax. the heart size is normal. the right picc line tip terminates in the mid-svc.
<unk> year old woman with aplastic anemia and new lll diminished, rhonchus breath sounds dull to percussion. vss // consolidation?
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with cp // ptx
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the lung volumes are normal. there are no pleural effusions. no lung nodules or masses. no other parenchymal abnormalities. normal hilar and mediastinal contours.
history of melanoma, evaluation of disease.
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exam is limited by patient positioning, patient's chin overlies the left lung apex the heart is moderately enlarged. there are perihilar opacities and increased interstitial markings compatible with pulmonary edema. there are also small to moderate bilateral pleural effusions with adjacent volume loss. there is no pneumothorax.
<unk>f with dyspnea // acute cardiopulm disease //history: <unk>f with dyspnea
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single ap upright chest radiograph demonstrates hyperinflated lungs and emphysematous changes. patchy bibasilar hazy opacities are noted most pronounced within the right lower lung zone. heart size is within normal limits. mediastinal and hilar silhouette is otherwise unremarkable. no overt pulmonary edema, large pleural effusion, or pneumothorax.
<unk>-year-old male with acute shortness of breath.
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pa and lateral views of the chest provided. lungs are hyperinflated and clear. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>m with hyponatremia, ams
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the lungs remain significantly hyperinflated in keeping with known copd. bilateral lower lobe opacity is have not substantially changed. bilateral lower reticular opacities in the lower lobes also suggests bronchiectasis. no pulmonary edema, no pleural effusions or pneumothorax. cardiac silhouette is not enlarged.
<unk> year old man with copd, worsening respiratory distress // worsening respiratory distress
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interval removal of a right-sided central venous line. dobbhoff feeding tube is again noted with the tip projecting over the left upper quadrant. multifocal opacities on the prior radiograph have improved with residual coarse reticular basilar lung opacities. trace left pleural effusion. mild ectasia to the ascending thoracic aorta. the cardiomediastinal silhouette is otherwise within normal limits.
history: <unk>m with gbm hx of asn pna presenting with concern for ams/seizure // pls eval for pna
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the ng tube and its side port are in the stomach. right port-a-cath has its tip in the lower svc. the lungs are clear without consolidation or edema. there is no pneumothorax or pleural effusion. the heart, mediastinal and hilar contours are normal.
<unk>-year-old man with advanced pancreatic cancer and nausea and vomiting, requires ng tube placement. ng tube slipped out last night. ng tube replaced and repositioned, check for placement.
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mild bibasilar opacities are probably reflect atelectasis. there is no pneumothorax or large pleural effusion. prominent pulmonary vessels are similar to before. mildly enlarged cardiac silhouette is similar to before. widened mediastinum likely reflect mediastinal fat as demonstrated on prior ct abdomen and pelvis.
<unk> year old woman with o<num> desat s/p lap cholecystectomy // ?pulmonary edema vs pna compare to prior study
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frontal and lateral views of the chest. lung apices are obscured due to patient's chin. the lungs however are grossly clear. there is no effusion or pulmonary vascular congestion. cardiomediastinal silhouette is slightly enlarged but stable. osseous and soft tissue structures are unremarkable.
<unk>-year-old male with increased seizures. question pneumonia.
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the lungs are clear, and the cardiomediastinal silhouette and hila are normal. there is no pleural effusion and no pneumothorax.
<unk>-year-old with chest pain.
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there has been no significant interval change. right-sided pleural thickening/chronic changes are stable. persistent mild elevation of the anterior right diaphragm. no new focal consolidation is seen. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. severe compression of a mid to lower thoracic vertebral body is grossly stable.
history: <unk>m with palps // please eval for pna
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the lungs are clear without consolidation, large effusion or edema. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with new aflutter // eval ? edema, infiltrate
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patient is status post cabg, with intact median sternotomy wires.the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unchanged.
history: <unk>m with chest pain // eval for pna
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the lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. the cardiac and mediastinal contours are normal.
<unk>f on plaquenil with cough and fever. evaluate for infiltrate.
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there are diffuse bilateral opacities, ? combined insterstial and alveolar opacities, with suggestion of faint nodular opacities in both lungs. no air bronchograms are identified. no effusion is seen. heart size is borderline enlarged. the cardiomediastinal silhouette appears slightly more prominent in comparison to prior study. post-surgical changes are noted in the cervical spine with fusion.
fever and cough.
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since <unk>, moderate bilateral perihilar and basilar opacities are increased. however, this may be technical in nature. moderate cardiomegaly is unchanged. support devices are in appropriate position. no pneumothorax.
<unk> year old woman with pulm edema, bipap dependent // interval change?
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frontal and lateral chest radiographdemonstrates well expanded lungs. no chf, focal infiltrate, pleural effusion or pneumothorax detected. heart size, mediastinal contour, and hila are unremarkable. limited assessment of the upper abdomen is within normal limits.
chest pain. assess for pneumothorax or mediastinal air.
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as compared to <unk>, the lungs remain markedly hyperinflated, consistent with copd. cardiomediastinal contours are stable in appearance. no new foci of consolidation are evident to suggest pneumonia. bilateral extrapleural masses are new, including a <num> cm lesion with associated apparent partial destruction of the right <unk> posterior lateral rib and a <num> cm pleural or extrapleural lesion adjacent to the seventh left posterior rib with associated slight rib deformity at this level. thoracic compression deformities and diffuse osseous demineralization are unchanged.
<unk> year old man with sob, pedal edema // ? chf
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frontal and lateral views of the chest were obtained. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. no displaced fracture is seen.
central chest pain, fever.
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the patient is status post median sternotomy and cabg. lung volumes are low with mild to moderate enlargement of the cardiac silhouette re- demonstrated. mediastinal and hilar contours are unchanged. crowding of the bronchovascular structures is present without overt pulmonary edema. no focal consolidation, pleural effusion or pneumothorax is present. there is minimal atelectasis at the lung bases. no acute osseous abnormalities seen.
history: <unk>m with weakness, shortness of breath
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there are large bilateral pleural effusions and associated atelectatic changes. right-sided pacemaker wires end in the right atrium and right ventricle. no pneumothorax. the cardiomediastinal silhouette and hila are normal.
<unk>-year-old woman with dyspnea.
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left-sided aicd/pacemaker device is noted with leads terminating in the right atrium, right ventricle, and coronary sinus, all unchanged. heart remains moderately enlarged. mediastinal contours are unremarkable. there is mild interstitial pulmonary edema, essentially unchanged compared to the prior exam. no pleural effusion, focal consolidation or pneumothorax is present. mild diffuse degenerative changes are seen in the thoracic spine. no acute osseous abnormalities are detected.
weakness, abdominal pain and elevated bilirubin.
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the lungs are hyperexpanded. there is new opacity at the left base in the retrocardiac region projecting over the spine on the lateral radiograph. mild bibasilar atelectasis or scarring. scoliosis limits evaluation of heart size. there is no pleural effusion or pneumothorax. the thoracic aorta is calcified and tortuous as before. again there is convex rightward curvature of the thoracic spine.
<unk> year old woman with persistent cough. hcvd, hocm // r/o pna, chf
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pa and lateral views of the chest provided. lung volumes are somewhat low. there is bronchovascular crowding likely accounting for subtle opacity at the right medial lung base. no convincing evidence for pneumonia. no large effusion or pneumothorax. no pulmonary edema or signs of congestion. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>m with fever, cough // pna?
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slight increase in mid to lower lung opacities due to moderate bilateral pleural effusions with overlying atelectasis ; associated moderate pulmonary edema is seen as well. underlying consolidation is difficult to exclude although no discrete focal consolidation is seen. cardiac and mediastinal silhouettes are grossly stable.
history: <unk>m with chf, copd, pleural effusions p/w dyspnea // eval effusions, consolidations
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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. clips in the right upper quadrant indicate prior cholecystectomy.
history: <unk>f with chest pain
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lung volumes are low. other than bilateral atelectasis, the lungs are clear. no pulmonary edema or focal consolidation. no pleural effusion or pneumothorax. the heart is normal in size. the mediastinum is not widened. the hila are within normal limits. the stomach is distended.
<unk> year old man with new o<num> requirment pod <num> from ileostomy takedown with mild tachycardia to the <num>s-low <num>'s // please evaluate for pulmonary process
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the endotracheal tube is in satisfactory position <num> cm from the carina. an enteric tube courses below the diaphragm with the tip out of field of view. an esophageal temperature probe is present with the tip in the mid esophagus. a right subclavian central venous catheter is present with the tip in the mid svc. the left central venous catheter has been removed. since prior exam, the lung volumes are lower. there is a linear opacity at the right base which likely represents atelectasis. no other opacity is identified. there is no pulmonary edema, pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal.
large subarachnoid hemorrhage. new fevers. evaluate for pneumonia.
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heart size is within normal limits. the cardiomediastinal silhouette is unremarkable. lung fields clear. a right chest port terminates in the low svc.
history: <unk>f with sob and tachycardia. hx of pe // ?pneumonia, pneumothorax, pulmonary edema
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the left chest tube remains present.no convincing pneumothorax detected. doubt significant interval change.
<unk> year old woman with s/p asd repair // eval ptx-ct clamped
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a portable frontal chest radiograph demonstrates an enlarged cardiac silhouette. increased opacity bilaterally is consistent with mild pulmonary edema and increased vascular markings consistent with a high flow state. increased opacity at the bases likely reflects small bilateral pleural effusions with associated atelectasis. there is no pneumothorax or focal consolidation. sclerosis of the humeral heads is consistent with avascular necrosis.
increased chest pain with intravenous fluid bolus, in a patient with sickle cell crisis. evaluate for pleural effusion or new pulmonary edema.
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pa lateral images of the chest. the lungs are well expanded clear. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is unremarkable.
persistent dry cough, no focal lung findings.
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cardiac, mediastinal and hilar contours are within normal limits. pulmonary vasculature is not engorged. lung volumes are low with patchy atelectasis noted in the lung bases. no focal consolidation, pleural effusion or pneumothorax is identified. there are mild degenerative changes noted in the thoracic spine. left subdiaphragmatic lucency likely reflects gas within a colonic loop of bowel.
history: <unk>m with multiple falls
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cardiac size is mildly enlarged, likely exaggerated by the ap projection. there is no pleural effusion. lung volumes are low. a retrocardiac opacity is noted and also seen on the lateral view which may represent a hiatal hernia, though more pronounced when compared with the prior exam. difficult to exclude a subjacent pneumonia/mass. bony structures appear intact.
<unk>m with weakness, hx of metastatic hepatocellular carcinioma // eval for pna
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a single portable semi-erect chest radiograph was obtained. a left internal jugular tunneled dialysis catheter tip terminates in the right atrium. lung volumes are low. basilar atelectasis is similar to appearance on <unk>. small pleural effusions have decreased in size. mild pulmonary vascular congestion is similar.
<unk>-year-old man status post renal transplant in <unk>, tracheobronchomalacia repair complicated by respiratory failure, tracheostomy, gastric perforation, now status post primary gastric repair.
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a radiopaque material measuring <num> cm, likely a capsule endoscopy given history, is seen between the ivc filter and the armoured tip of transesophageal tube, which is in the mid to low stomach. left large bore catheter terminates an right atrium, unchanged from prior. right picc terminates in the mid to low svc, unchanged from prior. the lungs are well expanded and clear. no pleural abnormality is seen. the heart is normal in size. the mediastinal and hilar contours are normal.
<unk> year old woman with capsule endoscopy likely retained in esophagus. evaluate for capsule.
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frontal and lateral views of the chest were obtained. lung volumes are low. small bibasilar linear opacities are unchanged and consistent with scarring or atelectasis. the lungs are otherwise clear without focal consolidation, pleural effusion, or pneumothorax. heart size and cardiomediastinal contours are normal. thoracic spine degenerative changes are similar to prior.
<unk>-year-old female with chest pain.
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right-sided pacer device is again noted with leads terminating in the right atrium and right ventricle. patient is status post transcatheter aortic valve replacement. mild enlargement of the cardiac silhouette is re- demonstrated. the aorta remains tortuous, and mediastinal contours are unchanged. enlargement of the pulmonary arteries bilaterally suggests underlying pulmonary arterial hypertension, unchanged. there is continued right hilar enlargement compatible with underlying mass lesion, with worsening streaky right basilar opacity likely reflecting a combination of mucous plugging and collapse of the right lung base, but superimposed infection is not excluded. within the lung apices, there is a similar appearance of scarring with bronchiectasis. no pleural effusion or pneumothorax is present. patient is status post right mastectomy with clips projecting over the right lower chest wall. loss of height of a mid thoracic vertebral body is unchanged. chronic left lateral rib fractures are again noted.
history: <unk>f with cough, dyspnea
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a new right internal jugular central venous catheter terminates in the upper-to-mid superior vena cava. there is no pneumothorax. moderate diffuse interstitial abnormality appears new. there is persistent patchy opacity in the left retrocardiac area with air bronchograms. there is likely a small pleural effusion on the left, but no convincing evidence for one on the right.
line placement.
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the lungs are clear without consolidation or edema. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal.
fevers.
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portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. mild engorgement of the pulmonary vasculature is new, suggestive early pulmonary edema. cardiomediastinal hilar contours are unchanged. no pneumothorax or pleural effusion. mild atelectasis at the bilateral bases has increased slightly over the interval.
<unk> year old woman with sat drop to <unk>'s, currently on <num> l nc, with crackles on exam // assess pulmonary status, look for pulmonary edema, effusion,
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portable single frontal chest radiograph was obtained. a right sided hd catheter terminates in the lower svc. the cardiac silhouette is moderately enlarged with mild pulmonary edema. small bilateral pleural effusions, left greater than right, are present with associated bibasilar atelectasis. indentation on the left trachea may reflect an enlarged goiter.
patient with chf, copd, esrd and respiratory distress, eval for volume overload versus pneumonia.
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compared to the prior study there is no significant interval change.
<unk> year old man with post-op // eval interval change
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a two-lead pacemaker device with leads terminating in the right ventricle and coronary sinus is noted. the heart appears normal in size. mild unfolding is noted along the thoracic aorta with calcification. heterogeneous opacification is noted along each lower lung. opacities are noted in both infrahilar regions, more extensive on the left than right. particularly striking is patchy mid and peripheral right lower lung opacities. it is difficult to exclude a small pleural effusion on the right given partial exclusion of the costophrenic sulcus. blunting of the left costophrenic sulcus may be due to a small effusion or chronic thickening. there is no pneumothorax.
arm edema.
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a nasogastric tube with the tip in the body of the stomach in good position. the remaining support device are in good position. left-sided loculated pleural effusion is stable. there is increasing loculated air surrounding the pigtail catheter. left retrocardiac opacity persists. a trace right-sided pleural effusion has developed. the right lung is otherwise clear.
<unk> year old woman with ngt // ngt placement
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pa and lateral views of the chest. no prior. the lungs are clear. there is no pneumothorax or pleural effusion. the cardiomediastinal silhouette is normal. the osseous and soft tissue structures are unremarkable.
<unk>-year-old male with chest pain.
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there has been interval resolution of the bilateral pulmonary edema and improvement of the bibasilar atelectasis. left small pleural effusion is stable. no new focal consolidations are seen. there is no pneumothorax. the median sternotomy wires are in place. there is stable, mild cardiomegaly. the hilar and mediastinal contours are otherwise normal.
<unk>-year-old female status post cabg, who presents for interval followup.
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moderate to severe cardiomegaly is unchanged. enlargement of the pulmonary arteries is stable. mild interstitial edema has minimally improved. there are no new lung abnormalities. pacer lead tip is in standard position. there is no pneumothorax or pleural effusion. there are mild degenerative changes in the thoracic spine
<unk> year old man with chf, new onset atrial flutter // evaluate volume status
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the lungs are clear with no evidence of consolidation, effusion, or pneumothorax. cardiomediastinal silhouette is normal. no aortic valve calcifications. no acute fractures are identified. right scapula and clavicle appear irregular and suggestive of either post-surgical changes or congenital abnormalities. diminished vasculature is also noted in the right upper lobe but may be due to decreased soft tissues in this region.
syncope.
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no focal opacity to suggest pneumonia is seen. no pleural effusion, pulmonary edema or pneumothorax is present. the heart size is normal.
abdominal pain, nausea and vomiting. skin rash.
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a central venous catheter ends at the low svc. no focal consolidation is seen. there is no evidence of pneumothorax or pleural effusion. the cardiac silhouette is mildly enlarged. enlargement of the pulmonary arteries is seen. views of the upper abdomen demonstrate surgical clips from prior cholecystectomy. no acute osseous abnormalities detected.
<unk>f with uri symptoms, pancreatic cancer on chemotherapy, evaluate for pneumonia.
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first image shows dobbhoff tube terminating just distal to the ge junction, and subsequent image shows dobbhoff tube terminating in the stomach. right ij venous catheter terminates at mid svc. pigtail catheter and another catheter inferiorly are noted at right upper quadrant of the abdomen. moderate right pleural effusion is unchanged. moderate cardiomegaly is unchanged. mild pulmonary vessel congestion is similar to prior.
<unk>m t<num>n<num> hilar cholangioca s/p l triseg/cbd exc/r-y hj <unk> c/b recurrent bile leak/abscesses,cholangitis p/w fevers, new hepatic lesions + cancer now s/p metal stent // evaluate dobhoff placement and positioning contact name: <unk>, <unk>: <unk>
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the heart size is moderately enlarged with a widening vascular pedicle. pulmonary vascular markings are indistinct and prominent in the upper lobes, compatible with mild edema. indistinct bilateral costophrenic angles are compatible with small effusions. bibasilar atelectasis is present. no focal consolidation or pneumothorax.
<unk>-year-old female with possible stemi. evaluate for infiltrate.
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again, there is a triangular-shaped opacity in the right mid lung zone, consistent with right middle lobe atelectasis. scarring in the right mid lung zone and along the left base is unchanged. the possible nodular opacity in the left upper lung zone appears similar to the prior exams and represents the costochondral junction. there is no new opacity, pulmonary edema, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is normal other than atherosclerotic calcifications at the aortic arch. an eventration of the right hemidiaphragm is unchanged. surgical clips in the right upper quadrant are likely from a prior cholecystectomy.
gait instability. evaluate for infection.
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dobbhoff tube tip terminates in the upper half of the esophagus. right picc tip terminates at the cavoatrial junction. lung volumes are hyperinflated. cardiac, mediastinal and hilar contours are unchanged. there is minimal streaky opacity in the retrocardiac region. no focal consolidation, pleural effusion or pneumothorax is visualized. there are no acute osseous abnormalities.
dobbhoff tube placement.
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the cardiomediastinal silhouette and pulmonary vasculature are normal. the lungs are clear. no pneumothorax or pleural effusion is noted.
<unk>m with cough
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normal heart size, mediastinal and hilar contours. lungs are well expanded and grossly clear except for minimal biapical scarring with possible small blebs. no focal consolidation, pleural effusion or pneumothorax
history: <unk>m with <num> days of hiccups // eval for lesion affecting diaphragm
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the lungs are hyperinflated as on prior. the degree of right apical opacity has increased since <unk>. linear opacity extending from the right hilum superolaterally may be due to atelectasis or scarring and is new from prior. at the lateral aspect of the scarring/atelectasis is new subtle focal opacity. right upper lobe fiducial marker is again noted. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities. old left rib fractures are again noted.
<unk>m with dyspnea, recurrent pneumonia, copd // pneumonia?
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there are small bilateral pleural effusions with concurrent opacities suggesting atelectasis, right worse than left. there is also coarsening of the vascular and interstitial markings more conspicuous in the right lower lung field. there is moderate aortic tortuosity and cardiomegaly. there is no evidence of pneumothorax. moderate degenerative changes of the left shoulder are incompletely evaluated.
<unk>-year-old female with altered mental status. evaluate for evidence of pneumonia.
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chronic scarring involving the bilateral upper lobes is not significantly changed in appearance, and is better characterized on prior ct. interval increase in heterogeneous opacification of the left lung, with more consolidative retrocardiac opacity containing air bronchograms, is most consistent with left lower lobe pneumonia. additionally, there has been interval development of the moderate-sized left pleural effusion. the heart remains enlarged. the aorta is tortuous. no pneumothorax.
<unk> year old woman with o<num> sat <unk>% ra, afebrile but breath sounds diminished per vna. chest xray prior to visit. // evaluate for pneumonia, effusion.
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compared with <num> day prior, i doubt significant interval change. again seen an aortic replacement device in relation to the ascending aorta. cardiomediastinal silhouette appears similar. possibility of slight volume loss on the left cannot be excluded, similar to prior. there are bilateral effusions with underlying collapse and/or consolidation, similar to prior. there is upper zone redistribution, consistent with chf, also overall similar to the prior film. the possibility of underlying parenchymal scarring cannot be excluded. compared to the prior film, there may be some increased opacity in both lung apices, though there is also more lordotic positioning on the current film. <num> drains, tapes or other devices overlie the upper chest. clips again noted in the region of the ge junction. left-sided picc line lies in the region of the cavoatrial junction.
<unk> year old woman with dchf, restrictive lung disease, worsening dyspnea // eval for pulm edema, pna
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moderate size left pneumothorax is slightly reduced with the apical component seen bordering the lower edge of the fourth rib, previously at the upper margin of the fifth. small hydropneumothorax at the left base is relatively unchanged. there is no evidence of tension. inferior to peristent subcutaneous emphysema along the left chest wall is a rectangular opacity most likely wound dressing, but should be confirmed by inspection. the right lung is unremarkable. there are no areas of focal consolidation. the cardiomediastinal silhouette is stable and normal.
<unk>-year-old male with pneumothorax status post chest tube removal.
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the upper lungs are clear. bibasilar atelectasis is minimal and unchanged. there is persistent bilateral pleural effusions. cardiomegaly is unchanged. the mediastinal and hilar contours are unremarkable. monitoring and support lines are appropriate in positioning. no pneumothorax.
<unk> year old man with hypercarbic resp failure now intubated // interval change
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the heart is mild to moderately enlarged. the superior vena cava is probably distended noting widening of the vascular pedicle. perihilar congestion is moderate and more generally there is widespread opacification suggesting mild to moderate pulmonary edema. there is no definite pleural effusion or pneumothorax.
dyspnea, weight gain and hypoxia.
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since prior, pleurx catheter has been removed. there is otherwise no change in a small right pleural effusion. there remains <unk> small air-fluid levels within the right lateral chest wall. the left lung is clear. the cardiomediastinal silhouette is unchanged. pacer wires are in standard position.
<unk> year old man with recurrent effusion s/p pleurx, assess for re-accumulation.
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the lungs are clear. the hilar and mediastinal contours are normal. there is no pneumothorax or pleural effusion. pulmonary vascularity is normal.
<unk>-year-old woman with malaise and cough. evaluate for pneumonia.
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frontal view of the chest was obtained. the heart is of top normal size. mediastinal contours are unremarkable. lungs are clear without focal consolidation, pleural effusion, or pneumothorax. no radiopaque foreign body.
<unk>-year-old female with palpitations. evaluate for cardiomegaly.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with <num> days of cough with productive sputum // eval for pna
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frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. hilar and mediastinal silhouettes are unremarkable. heart size is normal. there is no pulmonary edema. partially imaged upper abdomen demonstrates prominent air-filled large bowel loops.
chest pain, worse with breathing.
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endotracheal tube is well positioned, terminating <num> cm above the carina. left-sided central venous catheter does not cross midline and is likely within the distal aspect of the left brachiocephalic vein. enteric catheter courses below left hemidiaphragm and out of view. there is mildly increased bibasilar opacifications, left greater than right, which may reflect worsening pneumonia; however, there is also increased mild background pulmonary edema. cardiomediastinal and hilar contours are unchanged.
patient with mds status <unk> mud stem cell transplant, respiratory failure secondary to influenza/vap. evaluate endotracheal tube placement.
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the cardiomediastinal and hilar contours are stable, with a tortuous thoracic aorta. the lungs are clear, without consolidation, pulmonary edema, pleural effusion or pneumothorax. cervical spine fixation hardware is partially imaged.
<unk>-year-old woman with cough for five days.
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the lungs are normally expanded and clear. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. there is no pleural effusion or pneumothorax. a large osteophyte arises from a mid thoracic level on the left.
history: <unk>m with hx asthma presenting with dyspnea. +low grade fever, productive cough // eval for cardiopulmonary process
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the enteric tube extends into the stomach beyond view with side port beyond the ge junction. the endotracheal tube is approximately <num> cm above the carina. the heart is mildly enlarged. the mediastinal silhouette is unchanged although there is persistent leftward mediastinal shift. again seen is retrocardiac opacification with obscuring of the left hemidiaphragm likely secondary to left lower lobe collapse. the right lung is clear. small bilateral pleural effusions are likely present. there is no pneumothorax.
<unk> year old woman with hhs, seizure-like activity, intubated for airway protection // et tube placement, l lower lobe collapse?
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coronary arteries are heavily calcified. there is a moderate-to-large pleural effusion on the left, new since the prior study. associated left basilar atelectasis is likely. patchy right basilar opacity is not specific, but could be explained by atelectasis. there is no pneumothorax. a moderate-to-severe upper thoracic wedge compression deformity appears unchanged. mild degenerative changes are similar along the lower thoracic spine. a new contour deformity of the left sixth rib is incompletely characterized, but apparently new; however the single image of it is more suggestive of prior than recent injury.
status post fall, on coumadin. question injury.
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pa and lateral chest radiographs. there is no focal consolidation, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is within normal limits. <num>-mm nodular opacity overlying the anterior left <num>th rib may be a bone island or a prominent vessel.
shortness of breath.
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low lung volumes are present. heart size is mildly enlarged. widening of the superior mediastinum is likely due to supine positioning and low lung volumes. crowding of the bronchovascular structures is present. minimal patchy opacity in the left upper lung field may reflect an area of contusion or aspiration. no large pleural effusion or pneumothorax is present. no acute osseous abnormalities detected. surgical anchors overlie the right humeral head.
<unk> year old man status post fall (<unk> feet) from truck
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again seen is mild enlargement of the cardiac silhouette with tortuosity of the aorta, unchanged in appearance. the lungs are clear. the pleural surfaces are clear without effusion or pneumothorax.
history cough fever and asthma.
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frontal and lateral views of the chest were obtained. the patient is status post right upper chest wall resection, right upper lobectomy with right apical scarring and upward traction of the right hilum from radiation fibrosis, all unchanged. there is no pleural effusion or pneumothorax. the left lung is clear. heart size is normal.
<unk>-year-old woman with pleural effusion.
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dual lead pacemaker in situ with the lead tip seen in the right atrium and right ventricle. evidence of previous cabg procedure with sternal wires unchanged. evidence of previous cervical spinal fusion. marked pulmonary hyperinflation. no suspicious pulmonary nodule or mass. marked peripheral pruning of blood vessels. spondylotic changes of the thoracic spine.
<unk> year old man with weight loss, fatigue // r/o abnormality. former smoker