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The heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vascularity is normal. Linear opacity in the left lung base likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. Anterior bridging osteophytes are noted in the thoracic spine. Cervical spinal fusion hardware is re- demonstrated within the lower cervical spine.
fever.
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An ng tube is seen transversing past the diaphragm, but the tip is not within the field of view. A right-sided port-a-cath is present with the tip terminating in the low svc. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. There is mild hyperexpansion of the lungs which is unchanges from the prior exam. The cardiomediastinal silhouette is normal.
nausea, vomiting. evaluate ng tube.
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In comparison with the study of <unk>, the cardiac silhouette remains at the upper limits of normal or slightly enlarged. Pulmonary vascularity is essentially within normal limits. No evidence of acute pneumonia, rib fracture or pneumothorax.
foot pain and weight gain, to assess for pulmonary edema.
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Pa and lateral views of the chest provided. There is stable mild right hemidiaphragmatic elevation with right basal atelectasis again noted. Minimal atelectasis in the left lower lung also noted. There is no convincing sign of pneumonia. No effusion or pneumothorax. No signs of pulmonary edema. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>m with code stroke, right sided weakness // cva?
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The lungs are clear, without consolidation, pleural effusion or pneumothorax. Since the prior chest radiograph on <unk>, there has been interval normalization of the heart size, suggestive of resolving pericardial effusion. Upper abdomen is unremarkable.
<unk>f with chest pain, evaluate for effusion or pneumonia
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Tip of endotracheal tube terminates <num> cm above the carina with the neck in a flexed position. Cardiac silhouette is upper limits of normal in size, accompanied by pulmonary vascular congestion and minimal interstitial edema. Band-like atelectasis is present in the right mid lung region.
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Interval improvement in the density of the multifocal airspace opacification involving the upper, mid and lower right lung zones. Persistent left lower lobe atelectasis. Small bilateral pleural effusions. No pneumothorax.
<unk> year old woman with aspiration pna // assess consolidations
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There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The aorta is mildly tortuous. Contrast material is seen in the bowel.
<unk>-year-old woman with cns lymphoma and c<num>-<num> fracture, status post chemo with cough, dyspnea and dysphagia. question aspiration.
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Indeterminate nodule right lung apex, probably similar. Follow-up chest ct recommended. Mild bronchial wall thickening, stable. No consolidations. Degenerative arthritis bilateral shoulders. Remainder normal.
<unk> year old woman with copd and chest tightness // r/o pna
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In comparison with the study of <unk>, there is little change in the postoperative appearance involving the right hemithorax. No acute focal consolidation. There is some increased prominence of the pulmonary vessels in the left mid and lower zones, which most likely reflects either the patient in an ap supine versus pa projection, or possibly some asymmetric elevation of pulmonary venous pressure.
cirrhosis and copd with increased work of breathing.
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The endotracheal tube tip sits just beneath the level of clavicular heads, which is new from prior study. The heart size is large, but stable to prior exam. The mediastinal contours demonstrate calcified atherosclerotic disease of the aortic knob. A large calcified lymph node projects just right of midline. The interstitial markings of the lungs show minimally increased prominence as well as prominence of the pulmonary vasculature, compatible with mildly increased interstitial edema. There is no pneumothorax. No displaced rib fracture is apparent.
<unk>-year-old male who had been coded and received chest compressions and is now intubated.
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In comparison with the earlier study of this date, the orogastric tube extends well into the stomach with the tip at least in the lower body. Otherwise, little change.
og tube placement.
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Accounting for differences in technique, the cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. Lung volumes are low. Scattered airspace opacities are again seen, consistent with worsening multifocal pneumonia. Again noted is a left chest port with tip terminating in the mid svc. Surgical clips in the right axilla and absence of the right breast shadow correspond to history of breast malignancy.
hypoxia, shortness of breath.
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A feeding tube is partially evaluated but likely extends to the gastric body. Low bilateral lung volumes with right basilar opacities, particularly in the right lower lung zone and may reflect underlying consolidation. A small right pleural effusion is suspected. No pneumothorax. The size the cardiomediastinal silhouette is enlarged but unchanged.
<unk> year old man with recent pna, recently extubated. // c/f pulmonary edema vs worsening pna.
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In comparison with study of <unk>, there are slightly lower lung volumes. The dobbhoff tube has been removed and the left subclavian catheter remains in place. No evidence of pneumonia, vascular congestion, or pleural effusion.
seizures, to assess for pneumonia.
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The right subclavian line tip is at the upper to mid svc. Cardiac and mediastinal contours appear stable. The aorta is tortuous but stable. The lungs are clear and without a focal consolidation. There is no pleural effusion or pneumothorax. Multiple old healed right rib fractures are noted.
status post allogeneic transplant with cough and fatigue.
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There is no evidence of pneumothorax or pleural effusions. Moderate pulmonary edema is present. The heart is enlarged and this is stable when compared to the prior exam. The thoracic aorta is slightly ectatic. There is no evidence of pneumoperitoneum and osseous structures are grossly unchanged.
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Ap upright and lateral views of the chest are provided. The lung volumes are low. Bronchovascular crowding likely accounts for the subtle reticular opacities in the lower lungs. The cardiomediastinal silhouette is stable. Bony structures are intact. No pleural effusion or pneumothorax is seen.
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Ap single view of the chest has been obtained with patient in upright position. Comparison is made with the next preceding pa and lateral chest examination of <unk>. Status post sternotomy, as before. The metallic components of an apparent porcine aortic valve prosthesis can be identified in place. The heart size has not increased further beyond what has been identified on several postoperative chest examinations. There is now markedly increased pleural density on the right base obliterating the right-sided diaphragm and fluid accumulating along the lateral chest wall on the right side. This finding is new and has changed significantly from the last previous examination where some small lingering postoperative pleural effusions could be identified. A small caliber tube is overlying the left lower hemithorax and terminates within the heart shadow. It is assumed that it represents the pericardial drainage tube from the reported recent pericardiocentesis. Course of the rapidly developing right-sided pleural effusion is unclear. The accessible pulmonary vasculature does not show significant chf pattern and no pneumothorax is seen in the apical area. Referring physician, <unk>. <unk>, was paged. Acute pleural effusion, probably hamartoma related to pericardial drainage procedure was transmitted at <time> p.m.
a <unk>-year-old male patient with aortic stenosis, status post aortic valve replacement, presents with pericardial effusion and now status post pericardiocentesis, evaluate for any post-procedural complication such as pneumothorax.
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There is a widespread interstitial abnormality that is increased and suggestive of moderate interstitial pulmonary edema. There are apparently substantial degenerative changes of the shoulder, but not well evaluated here. There is similar moderate relative elevation of the right hemidiaphragm compared to the left due to an anterior eventration. Cholecystectomy clips project over the right upper quadrant. There is exaggerated kyphosis and similar degenerative changes at the thoracolumbar junction.
left shoulder pain. question pneumothorax or pneumonia.
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Frontal and lateral chest radiograph demonstrates moderate left-sided pleural effusion which does not appear to be freely layering. The right lung is grossly clear. There is a left lower lobe consolidation most likely atelectasis. There is no pneumothorax. Heart size is top normal. Hilar and mediastinal contour is within normal limits.
<unk>-year-old female with alcoholic cirrhosis status post liver transplant. evaluate for pleural effusions.
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Pa and lateral views of the chest provided. Streaky lucencies overlying the mediastinum noted concerning for pneumomediastinum. No focal consolidation, effusion or pneumothorax. Heart size is normal. Bony structures are intact.
<unk>f with chest pain // ? pna
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Lung volumes are extremely low, accentuating cardiomediastinal contours and resulting in crowding of bronchovascular structures. This is further accentuated by baseline elevation of right hemidiaphragm. With these limitations in mind, there has probably not been a substantial change in the appearance of the chest since the recent radiograph of <unk> except for worsening bibasilar atelectasis and potentially development of small pleural effusions. Repeat radiograph with improved inspiratory level would be helpful for more complete assessment when the patient's condition permits.
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The lungs are clear, the cardiomediastinal silhouette and hila are normal. There is no pleural effusion or pneumothorax.
<unk>-year-old with chest pain.
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Lungs are clear. The heart is mildly enlarged. The mediastinal silhouette, hilar contours, and pleural surfaces are normal. No pneumothorax, pleural effusion, or pulmonary edema. No focal consolidations are noted. There are no obvious left rib or scapular fractures on this limited exam although this study has limited sensitivity for the detection of such.
history: <unk>m s/p assault, now with left sided scapular and rib pain // rib fracture
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The heart size is normal. The aortic knob is calcified. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Apart from minimal subsegmental atelectasis in the lung bases, the lungs are clear. No pleural effusion or pneumothorax is seen. There is hyperinflation of the lungs which is suggestive of underlying copd. Multilevel degenerative changes with anterior bridging osteophytes are noted in the thoracic spine. No acute osseous abnormality is visualized.
right upper back pain after motor vehicle collision.
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The lungs appear clear without focal consolidation, effusion or pneumothorax. Heart size and mediastinal contours are stable with an unfolded thoracic aorta containing moderate atherosclerotic calcifications.
<unk>-year-old woman with altered mental status.
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The lung volumes are low on the lateral view. There is no pleural effusion or pneumothorax. Atelectasis is seen at the bases. The hilar structures and mediastinum contours are unchanged. Calcifications are again seen in the aortic knob. The heart size is stable. Clips are seen overlying the neck. There is a mild s-shaped curvature to the thoracolumbar spine. Degenerative changes of the right shoulder seen, including it being high ridingin position, which can be seen in rotator cuff disease. Moderate degenerative changes of the thoracic spine are noted.
cough, congestion shortness of breath. evaluate for pneumonia.
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In comparison with study of <unk>, there is no evidence of pneumothorax. Free intraperitoneal gas would be difficult to detect since this patient may not have been in an upright position sufficiently long for gas to accumulate under the hemidiaphragm. Diffuse interstitial changes are again seen bilaterally, most likely reflecting chronic pulmonary disease. The possibility of supervening pneumonia would have to be considered in the appropriate clinical setting.
shortness of breath after ercp.
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As compared to the previous radiograph, the left chest tube has been removed. The patient continues to show an atelectasis at the right lung base. The fusion devices are seen in unchanged manner. Borderline size of the cardiac silhouette. No pneumothorax. No pulmonary edema.
rule out pneumothorax after spine fusion.
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Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable.
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The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable.
history: <unk>f with left sided chest pain and sob // evaluate for pulmonary pathology
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Pa and lateral views of the chest are compared to previous exam from <unk>. The lungs are clear. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.
<unk>-year-old man with chest pain.
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No focal consolidation is seen. There is no large pleural effusion or pneumothorax. Cardiac silhouette size is top-normal. The aorta is slightly tortuous. No pulmonary edema is seen.
<unk> year old man with exertional chest pain // r/o infection or pleural effusions
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Two portable views of the chest. The lungs are grossly clear within limitation of patient's positioning and the lung apices are obscured by the patient's chin. There is rotation to the left. The cardiomediastinal silhouette is grossly unremarkable, although atherosclerotic calcifications are noted at the aortic arch. Left-sided picc is identified, although the tip is difficult to assess in positioning given patient's positioning. Tubes also project over the abdomen bilaterally.
<unk>-year-old female with fatigue and lethargy.
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Pa and lateral images of the chest. The lungs well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable.
chest pain.
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The lungs are clear besides mild bibasilar atelectasis. There is no effusion or consolidation worrisome for pneumonia. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. No free intraperitoneal air.
<unk>f with ruq pain, recent ccy, ?cbd stone // eval for acute process, pleural effusion, free aireval for cbd dilation
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As compared to the previous radiograph, there is unchanged evidence of a right picc line and of a left pectoral pacemaker. The size of the cardiac silhouette has minimally increased, given lower lung volumes, presumably caused by a lesser inspiratory effort. There is no overt pulmonary edema. Areas of bilateral atelectasis, left more than right, are seen. No evidence of pneumonia. No pneumothorax.
shortness of breath, rule out pulmonary edema.
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Again seen are bilateral pleural effusions, right greater than left, and slightly increased from prior. Fluid seen within the right minor fissure. There is pulmonary vascular congestion without overt edema. Moderate cardiomegaly is again noted as well as a dual lead left chest wall pacing device. Tortuosity of the descending thoracic aorta with atherosclerotic calcifications at the arch. No acute osseous abnormalities.
<unk>f with dyspnea // r/o pna
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The dobbhoff tube terminates in the stomach. The cardiomediastinal silhouette is unchanged and normal. There is likely a small left pleural effusion and minimal atelectasis at the left base. The right lung is clear. No evidence of pneumothorax.
<unk> year old man with w/l cerebellar hemorrhage w/sinusitis and vent dependence s/p trach // interval change
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The heart is again mildly enlarged. There is similar mild unfolding of the thoracic aorta as well as calcification visualized along the arch. There is a new small-to-moderate right-sided pleural effusion that prominently layers along the right lateral chest wall as well as new patchy right basilar opacity obscuring the left hemidiaphragm. The lateral view suggests a developing posterior consolidation in the right lower lobe. There are also new small patchy left basilar opacities obscuring the lateral side of the left hemidiaphragm. Fissures are also thickened reflecting pleural fluid on the right. Mild degenerative changes are similar along the lower thoracic spine.
chest pain.
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The heart is at the upper limits of normal size. The cardiac, mediastinal and hilar contours appear unchanged. Incompletely characterized post-surgical changes are similar along the sternum. A single fiducial marker projects over the mid posterior right chest in a similar position.
supraventricular tachycardia. question cardiomegaly.
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The lungs are clear, no acute focal consolidation. No pleural effusions or pneumothorax. Widening of the right paratracheal stripe and the surgical clips in the upper mediastinum related to known tracheal ring.
<unk> year old woman with h/o tracheal ring, uri sypmtoms but bilateral wheezing and crackles on exam // ? pna
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The ng tube has been removed. The endotracheal tube. Terminates at the level of the clavicles. New blunting of the left costophrenic angle is likely due to a small pleural effusion. The lungs are clear. There is no pneumothorax. The heart and mediastinum are magnified by the projection.
<unk> year old woman with intubation // ? position of et tube
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The right-sided port-a-cath tip terminates at the cavoatrial junction, unchanged. Mild cardiomegaly is also unchanged. Lungs remain hyperinflated with emphysema most pronounced at the lung apices. Compared to the prior studies, there is new minimal interstitial edema denoted by new linear opacities radiating from the hilar regions bilaterally. Minimal pulmonary vascular congestion. Minimal streaky opacities in the right lung base, likely due to scarring or atelectasis. No focal consolidation, pleural effusion, or pneumothorax.
<unk> year old man with gastric cancer presents with <num>wks luq pain. missed for hemodialysis sessions. evaluate for acute process, pneumonia, or pulmonary edema.
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Ap upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Anterior spurring in the mid to low thoracic spine is noted. No free air below the right hemidiaphragm is seen.
history: <unk>f with falls // eval infiltrate
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Port-a-cath in place. Shallow inspiration. Prominent pulmonary vascularity, stable. Bibasilar opacities, worsened on the right, similar on the left. Bilateral pleural effusions, similar. Surgical clips right upper quadrant.
<unk>m with recurrent aspiration pneumonias presenting after an episode of vomiting with increased o<num> requirement and tachycardia // worsening infiltrate?
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Pa and lateral images of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable. No displaced rib fractures are seen.
fall, altered mental status.
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Right chest tube has been removed. There is no pneumothorax. Surgical suture material is noted medial right upper lung, consistent with history of right upper lobe wedge resection. Mild basilar opacities are likely secondary to atelectasis and/or small pleural effusions. Cardiac silhouette is normal size. There is no pulmonary edema.
<unk> year old man s/p vats rul wedge // r/o ptx post ct removal
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Frontal and lateral views of the chest. Previously seen right picc is no longer visualized. There is new small patchy opacity at the left lower lung laterally, not seen clearly on the previous exam. Elsewhere, the lungs are grossly clear. There is no overt pulmonary edema. There is, however, enlargement of the cardiac silhouette, suggesting mild cardiomegaly. No acute osseous abnormality is identified.
<unk>-year-old man with new onset of afib and dyspnea.
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Ap upright and lateral views of the chest provided. Lung volumes are low. Stable cardiomegaly. Hilar congestion and mild interstitial edema is suspected. No large effusion or pneumothorax. No convincing signs of pneumonia. Chronic right rib deformities again seen. Gas-filled loops of bowel seen below the diaphragm.
<unk>m with aspiration event in ed now requiring o<num>
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Pa and lateral views of the chest. The right upper lobe mass is again seen measuring <num> cm ap x <num> cm cc x approximately <num> cm trv. Otherwise, the lungs are clear without evidence of consolidation. Nodular opacities seen on prior ct are not clearly delineated by this chest x-ray. There is no evidence of pulmonary vascular congestion. Cardiomediastinal silhouette and osseous structures are unchanged.
<unk>-year-old male with non-small cell lung cancer with shortness of breath. question chf.
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The large loculated right pleural effusion is unchanged. The fluid loculation within the major fissure is likely unchanged as well. A new left pleural drain has been placed and the small left pleural effusion has resolved. A right pleural drain is in unchanged position. Unchanged bilateral mediastinal clips are noted.there is no focal consolidation, pneumothorax, or pulmonary edema.
<unk> year old man with pleural effusion // eval
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The lung volumes are normal. No evidence of pneumonia. No other lung parenchymal pathology. Small hiatal hernia. Normal size of the cardiac silhouette. No pleural effusions.
cough, evaluation for pneumonia.
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Ap upright portable view of the chest was obtained. The patient is status post median sternotomy. Mild cardiomegaly persists. There are relatively low lung volumes. There is mild pulmonary vascular congestion. The aorta is calcified and tortuous. Cardiac and mediastinal silhouettes are stable. No definite focal consolidation or large pleural effusion is seen. No displaced fracture.
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Minimal lateral right base atelectasis is seen. There is no definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Degenerative changes are noted along these thoracic spine. No displaced fracture is seen, although, ct is more sensitive.
history: <unk>f with left chest injury // eval for chest wall injury
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Compared with the prior radiograph, interval decrease in the degree of pulmonary edema. The right-sided dual port-a-cath with tip projecting at the cavoatrial junction is unchanged. Bilateral pleural effusions have decreased in size, with a residual small left effusion.
<unk> year old woman with aml and volume overload with effusions on previous ct. ?worsening effusions, ?pulm edema
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Feeding tube has been advanced, now terminating in the upper stomach. Cardiomediastinal contours are unchanged. Lung volumes are increased, and lungs are grossly clear.
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There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Incidental note is made of resection of the anterior right first rib.
<unk>f with chest pain, dyspnea, evaluate for acute cardiopulm disease.
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No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Heart and mediastinal contours are within normal limits.
<unk>-year-old female with chest pain.
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No focal consolidation is seen. There is no evidence of large pleural effusions; however no lateral view obtained, which can be more sensitive to assess for posteriorly larynx pleural fluid. No pneumothorax is seen. The aorta is calcified and tortuous. The cardiac silhouette is top-normal.
history: <unk>f with ?pleural effusion on osh ct, pls eval for interval change // history: <unk>f with ?pleural effusion on osh ct, pls eval for interval change
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The tip of the right picc line is again noted to be extending up into the right jugular system. No focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiomediastinal silhouette is unchanged. Interval removal of the endotracheal and gastric tubes. Re- demonstrated is thoracic dextroscoliosis with a spinal rod.
<unk> year old woman with malpositioned r picc w/ tip in ij // s/p power flush in attempt to reposition picc into svc. please evaluate picc position.
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Lung volumes are low. Mild cardiomegaly is unchanged. Mediastinal and hilar contours are within normal limits. There is mild crowding of bronchovascular structures without pulmonary edema. Streaky atelectasis is noted in the lung bases without focal consolidation. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. Fusion hardware within the cervical spine is incompletely assessed.
history: <unk>f with cough, subjective fever, resolved headache but right sided weakness and slowed speech
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Frontal and lateral chest radiograph demonstrates unchanged cardiomediastinal contours. The lungs are clear. No pleural effusion or pneumothorax. There is interval removal of left-sided picc line. Mild unchanged elevation of the right hemidiaphragm. No osseous abnormalities are identified.
postoperative fever.
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Frontal and lateral views of the chest are obtained. A right-sided port-a-cath is seen, terminating at the cavoatrial junction, unchanged in position. Calcified appearing reticular nodular opacities at the bilateral lung apices are stable. Right base linear atelectasis/scarring is seen. There is no focal consolidation, pleural effusion, or evidence of pneumothorax. Cardiac and mediastinal silhouettes are stable and unremarkable.
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In comparison with study of <unk>, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Of incidental note is total shoulder arthroplasty on the right and a cervical fusion device.
cough in smoker.
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Portable single frontal chest x-ray was obtained with the patient in upright position. A right picc terminates in the lower svc. There is no evidence of complications or pneumothorax. There is mild cardiomegaly with vascular congestion. No focal consolidation, pleural effusion, or pneumothorax is seen.
new right picc line, eval placement.
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In comparison with the study of <unk>, there has been placement of a nasogastric tube that extends into the stomach with the side hole probably just distal to the esophagogastric junction. Allowing for differences in projection from the pa to ap, there is probably little change in the appearance of the heart and lungs since the earlier study of this date.
ng tube placement.
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The cardiac, mediastinal and hilar contours appear unchanged. There are streaky opacities at the left lung base but decreased compared to the prior study, most suggestive of improving atelectasis. There is no pleural effusion or pneumothorax. Internal-external biliary drains have been revised in two internal drains.
fever.
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Pa and lateral views of the chest. The lungs are clear. There is mild cardiomegaly. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Slightly low lung volumes.
<unk>-year-old female with cough, evaluate for pneumonia.
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There is diffuse airspace opacification of the right upper lung consistent with the right upper lobe pneumonia. Indistinct airspace opacities in the left lung base may represent atelectasis or an additional site of consolidation. There is no pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.
<unk>f with cough x <num> weeks evaluate for pneumonia.
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Ap single view of the chest has been obtained with patient in semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of <unk>. Drooping head and chin are obscuring apical portion of the lungs and makes it impossible to accurately inspect the superior trachea. It is assumed that the ett present on the previous examination has been removed. No pneumothorax can be identified. The pulmonary vasculature is unaltered and there is no evidence of any new acute parenchymal infiltrate. Similar as on the preceding examination, the high positioned diaphragms result in crowded appearance of the basal pulmonary vasculature with some linear densities on the left base most likely representing plate atelectasis. The diaphragmatic contours can be identified and thus there is no evidence of significant pleural effusion on either side. Smaller amounts of pleural effusion would require a lateral view to be seen in the posterior dependent pleural sinuses. Cardiac enlargement of moderate degree is again seen and within the heart shadow, one can identify a band of calcium representing mitral annulus calcifications.
<unk>-year-old female patient admitted for seizures, treated for possible pneumonia, with elevated white blood count and shortness of breath. evaluate.
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Cardiomediastinal contours are within normal limits and without change. Lungs and pleural surfaces are clear. Sclerotic focus on the left sixth anterior rib is without change and has been previously attributed to a bone island on ct torso of <unk>. Mild elevation of right hemidiaphragm is again demonstrated.
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Support and monitoring devices are unchanged in position. A <num> cm diameter mass-like opacity in the periphery of the left upper lobe appears slightly less solid than on the prior study with greater heterogeneity. Additionally, there is improved aeration between the mass and the adjacent left hilar structures. Surrounding consolidation also appears slightly improved. Observed findings could be due to an improving infectious pneumonia, but co-existing neoplasm is of concern given marked narrowing of left upper lobe bronchus on prior ct torso of <unk> and the rounded contour of this region of increased opacity. Left retrocardiac opacity is unchanged, but a small left pleural effusion has slightly decreased in size. Pulmonary vascular congestion has worsened and is accompanied by increasing interstitial edema and a small right pleural effusion.
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The cardiomediastinal shadow is normal. There is mild vascular congestion and parahilar peribronchial cuffing. No pulmonary edema no airspace consolidation. No pneumothorax. No pleural effusion. No sinister bony lesions.
<unk> year old woman with dka, persistent chest pain, leukocytosis // pna?
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The cardiomediastinal and hilar contours are normal. Specifically, there is no evidence of lymphadenopathy or mediastinal mass. The lungs are clear. There is no pleural effusion or pneumothorax.
<unk>-year-old female with difficult to control hypertension.
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Ap and lateral views of the chest. No prior. The lungs are clear of consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.
<unk>-year-old male with shortness of breath and seizure. question pneumonia.
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A right-sided picc line is unchanged in position, terminating just beyond the superior cavoatrial junction. There is no pneumothorax. Evaluation of the lung parenchyma is somewhat limited by low lung volumes. However, new increased opacification at both lung bases may be due to subsegmental atelectasis, infection or aspiration. Pulmonary vascular congestion and interstitial edema are new. There are new small bilateral pleural effusions.
<unk> year old man with fever. evaluate for pneumonia.
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The lung volumes are low and there is bibasilar atelectasis. Otherwise, the lungs are clear without focal opacities, pleural effusion or pneumothorax. The cardiac and mediastinal contours are stable. A vascular stent projects over the trachea. A nasogastric tube ends in the stomach.
history: <unk>m s/p attempted r ij line (no line placed) // eval for pneumothorax or hematoma
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Pa and lateral views of chest demonstrate the patient is status post right wedge resection with chain sutures in the right midlung with associated volume loss and vague opacity in the midlung is unchanged, likely post-surgical. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema or focal consolidation. No pneumothorax is identified.
right-sided chest pain. evaluation for pneumonia.
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Allowing for lower lung volumes on the current study, there has not been a substantial short interval change in the appearance of multifocal bilateral areas of consolidation.
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Median sternotomy wires are intact and well aligned. The patient has undergone prior aortic valve replacement. There has been interval removal of a right central venous catheter. The cardiac silhouette is borderline enlarged. The pulmonary vasculature is unremarkable. A right pleural effusion remains. No pneumothorax is present.
<unk>m with valve replacement <num> months prior now w/ worsening cp radiating to scapula x <num>d
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Lung volumes are low, but there are no focal opacities. A nodular opacity just below the margin of the right hemidiaphragm represents a calcified granuloma seen in prior ct. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. A right-sided port-a-cath ends in the lower svc, unchanged from prior.
altered mental status. evaluate for cardiopulmonary disease.
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Pa and lateral views of the chest. The lungs are clear. The cardiac, mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax.
<unk>-year-old female with increasing cough, evaluate for pneumonia.
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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 pancreatitis, sob, chest pain.
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A right chest port-a-cath terminates in the low svc. Bibasilar patchy opacities likely reflect atelectasis. No focal consolidations to suggest pneumonia. Stable appearance of the cardiomediastinal silhouette. No pulmonary edema. Multiple chronic left rib fractures are re- demonstrated, as well as a compression deformity of the l<num> vertebral body.
<unk>f with fever // fever
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Extensive lobar right upper lobe and left lower lobe opacifications are stable. Mediastinal contours heart size are unchanged. Support lines are stable.
<unk>f w/acutely worsening respiratory status, please eval for interval change //
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In comparison with the study of <unk>, there is enlargement of the cardiac silhouette with some further engorgement of the pulmonary vessels consistent with the clinical suspicion of overhydration. Left and probably right pleural effusions with some compressive atelectasis at the bases.
copd with flu-like symptoms.
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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.
history: <unk>f with chest pain // eval for infiltrate, widened mediastinum
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Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation.
<unk>-year-old man with chest pain.
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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, inspirational, pleuritic
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Cardiac silhouette remains enlarged. Pulmonary edema has improved with residual minimal interstitial edema remaining. Patchy and linear atelectasis at left lung bases is also slightly better. Small pleural effusions are probably unchanged in the interval. Compression deformity at the thoracolumbar junction has been present on older studies dating back to at least <unk>.
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Frontal and lateral radiographs of the chest demonstrate slight increase in lung volumes with otherwise clear lungs. The cardiac and mediastinal contours are normal. No pleural effusion or pneumothorax is seen.
shortness of breath. evaluate for interval change.
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Multifocal areas of consolidation rapidly progressed between <unk> and <unk>, with the appearance on ct of <unk>, attributed to a multifocal pneumonia. When comparing the scout image from the recent ct as a surrogate for a chest radiograph at that time point, the main radiographic change is development of increasing volume loss in the right upper lobe, manifested by elevation of the minor fissure. The right upper lobe remains densely consolidated, particularly centrally, and has more hazy ground-glass and in the periphery. An area of combined consolidation and ground-glass in the periphery of the left upper lobe is similar to slightly improved, and a predominant ground-glass opacity within the right lung base is unchanged. A new area of patchy and linear opacity has developed in the left lower lobe and may reflect additional site of infection. Poorly defined opacities in the juxtahilar regions are unchanged. Bilateral pleural effusions are small and similar to the recent ct. Fullness of the hilar and right paratracheal contours likely reflects reactive lymphadenopathy.
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Marked cardiomegaly is stable from the most recent prior examination. There is mild pulmonary vascular congestion and mild interstitial edema. There are no pleural effusions or pneumothorax. Opacity at the base of the right lung likely reflects mediastinal fat, scarring and atelectasis as demonstrated on recent ct.
history: <unk>f with cough // ?pna
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In comparison with the study of <unk>, the monitoring and support devices remain in place. Again, there is substantial elevation of the right hemidiaphragmatic contour. Low lung volumes accentuate the transverse diameter of the heart. There is some ill-defined vascular structures suggesting elevated pulmonary venous pressure. Atelectatic changes are seen at both bases, especially on the right. In the appropriate clinical setting, a developing consolidation at the right base would have to be considered. The opaque portion of the dobbhoff tube may straddle the esophagogastric junction. If clinically possible, the tube should be advanced several centimeters.
hypoxemia.
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Pa and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormality is identified.
<unk>-year-old female with cough and shortness of breath.
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The lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. Coils are noted in the upper abdomen on the lateral radiograph.
<unk>-year-old male with chest pain.
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The cardiomediastinal and hilar contours are stable. There is no pneumothorax. Previously noted right pleural effusion is no longer apparent. A small to moderate left pleural effusion is decreased in size compared to prior. The lungs are well-expanded without focal consolidation concerning for pneumonia. Post cabg changes are noted. Pacemaker leads are in unchanged position.
<unk>f with sob
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Ap and lateral views of the chest are compared to previous exam from <unk>. The previously identified right picc, left subclavian line and right neck skin <unk> are no longer seen. Lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. The aorta is slightly tortuous with atherosclerotic calcifications. Degenerative changes noted at the glenohumeral and right acromioclavicular joint.
<unk>-year-old female with syncope.