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Portable supine chest radiograph is obtained. Density projecting over the left chest is compatible with a bullet fragment. Humeral fracture is incompletely assessed. Keys project over the right lower hemithorax. The lungs otherwise appear well expanded without pneumothorax, pleural effusion or focal consolidation. The heart and mediastinum is unremarkable.
gunshot wound to pelvis, assess for traumatic injury.
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Single frontal view of the chest demonstrates stable configuration of a left transthoracic chest catheter with a pigtail terminating apically. There is a persistent moderate left apical pneumothorax, unchanged since <unk>:<num> on <unk>, but decreased since <unk>:<num> on <unk>. There is persistent lingular atelectasis. Patient is rotated to the right, limiting assessment of the cardiomediastinum. There is no right pneumothorax. Lung volumes remain decreased. Small amounts of bilateral subcutaneous emphysema persist. Known left mid clavicular fracture has been reduced to near anatomic position. A few known left-sided rib fractures are not well seen.
<unk>-year-old female who fell <unk> steps with left pneumothorax, here for assessment of resolution.
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Patient is status post esophagectomy. Since <unk>, worsening bilateral multifocal heterogenous opacities, predominantly in the lung bases but including the right middle lobe, lingula, and left upper lobe, could reflect multifocal pneumonia or recurrent aspiration following the esophagectomy. Unchanged hyperinflation of the lungs. Small bilateral pleural effusions persist. The heart size is unchanged. No pneumothorax.
<unk> year old man s/p mie w/ pna // check interval change
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The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.
weakness, bradycardia.
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Heart size is top normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Subtle opacity in the right lower lobe is concerning for infection. No pleural effusion or pneumothorax is seen. A ventriculoperitoneal shunt is partially imaged and appears grossly intact.
<unk>f with leukocystosis // eval for pna
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As compared to the previous radiograph, the lung volumes have minimally increased. However, the changes indicative of peripheral lung fibrosis, documented on multiple previous examinations, are unchanged in extent and severity. No evidence of exacerbations. No new opacities. Unchanged borderline size of the cardiac silhouette without evidence of pulmonary edema. No pleural effusions.
history of interstitial pneumonitis, re-assessment.
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There is stable mild enlargement of the cardiac silhouette. There is mild pulmonary edema. There may be a small right pleural effusion. No focal consolidation or pneumothorax. The median sternotomy wires are intact.
history: <unk>f with chf, pafib, coming in with gi bleeding and sob. // e/o pna
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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.
status post mechanical fall.
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There is moderate cardiomegaly. The aorta is tortuous. There is no pneumothorax. Bilateral effusions are better seen in concurrent abdomen ct. There is mild vascular congestion.
<unk> year old man with sob and svt // r/o pneumonia
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A left subclavian central venous catheter terminates near the superior cavoatrial junction. However, the proximal portion of the catheter appears kinked, though it is difficult to ascertain whether or not this contour change is external or internal to the patient. New lateral right basilar opacities likely reflect atelectasis. Otherwise, no significant changes compared to <num> hours prior.
<unk> year old female found unresponsive with seizure activity, found on ct to have extensive acute bilateral frontal and parietal lobe infarcts in the setting of chronic infarcts, intubated with continued seizure activity on eeg, concern for takotsubo as well as rhabdo with ck ><unk>,<num> now <unk>. continues with poor neuro exam. // protocol cxr to troubleshoot subclavian port <unk> not withdrawing
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The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. A <num> cm well-circumscribed opacity projects over the left heart border but disappears upon patient repositioning. The cardiac and mediastinal contours are normal. There is no displaced rib fracture.
bike accident.
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Pa and lateral views of the chest. No prior. The lungs are clear of focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old man with chronic cough and shortness of breath. please rule out atypical pneumonia versus active tb.
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Mild cardiomegaly is re- demonstrated. The mediastinal and hilar contours are similar. The pulmonary vasculature is not engorged. Patchy atelectasis is noted in the lung bases without focal consolidation. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities.
history: <unk>f with fevers and cough
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In comparison with the study of <unk> from an outside facility, the cardiac silhouette is within normal limits. There are bilateral effusions with compressive atelectasis at the bases and some indistinctness of pulmonary vessels suggesting elevated pulmonary venous pressure. There is some prominence of the left hilar region. It is unclear whether this is merely a reflection of central edema or a sign of an infectious or even neoplastic process. This area should be closely scrutinized on subsequent images. There is some area of increased opacification in the retrocardiac region on the lateral view. This overlies the somewhat calcified aorta and may merely reflect superimposed normal markings. However, if there is serious concern for infectious process, an area of consolidation could be considered.
shortness of breath.
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As compared to the previous radiograph, there is no relevant change. Minimal fluid overload and moderate cardiomegaly. No evidence of pneumonia. No pleural effusions. Unchanged position of the dobbhoff catheter.
likely stroke, evaluation for pneumonia.
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Comparison is made to previous study performed <num> hours earlier. There is an endotracheal tube, left-sided picc line, right-sided central line, right ij central line, nasogastric tube, and endotracheal tube which are all appropriately sited and unchanged. The heart size is enlarged. There is a persistent left retrocardiac opacity. There is some atelectasis at the lung bases and likely a left-sided pleural effusion which is stable. There are no signs for overt pulmonary edema or pneumothoraces.
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A pacemaker generator is seen projected over the left chest wall with a single lead terminating adjacent to the right ventricle. The lungs are clear. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are normal without effusion or pneumothorax.
progressive dyspnea and cough.
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Patchy right lower lobe opacity may reflect atelectasis versus pneumonia. There is no pleural effusion, pneumothorax or pulmonary edema. The heart is normal in size.
<unk>-year-old male with productive cough. evaluate for pneumonia.
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Pa and lateral views of the chest were obtained. Lungs are clear. No free air below the right hemidiaphragm. Cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. Bony structures are intact. Clips in the right upper quadrant noted.
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The right costophrenic sulcus is not included. The left costophrenic angle is blunted. Increased density is again demonstrated in the left lower lobe. This appears slightly more extensive than before. The heart and mediastinal structures are stable in appearance. A nasogastric tube remains in place.
gastric distention, gastric outlet obstruction, ngt placement interval eval. please do at <num>am
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The cardiac silhouette size is unchanged and top normal. The mediastinal and hilar contours are within normal limits. Mild calcification of the aortic arch is present. The pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present.
chest pain.
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Heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal. Subsegmental atelectasis in the lingula is noted. Minimal blunting of the left costophrenic angle is again seen, likely chronic pleural thickening. No focal consolidation, pleural effusion or pneumothorax is identified. The lungs are hyperinflated. Multiple clips are demonstrated within the left upper quadrant. There are no acute osseous abnormalities.
asthma and dyspnea.
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Right-sided central venous catheter is again seen. There is been interval development of a large right pleural effusion with underlying atelectasis. There is also small left pleural effusion. Where aerated, the lungs are clear of confluent consolidation noting vascular congestion. The cardiomediastinal silhouette cannot be accurately assessed.
<unk>m with shortness of breath // eval for volume overload
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The lungs are hyperexpanded and clear. Compared to the prior chest radiograph pulmonary edema has completely resolved. There is no focal opacity or pneumothorax. A tiny right pleural effusion is possible. The aortic knob is calcified. The heart size is normal. There is no free intra-abdominal air.
<unk>f with hematemesis vs upper gib. evaluate for pneumonia lung lesions and free air.
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Small right pleural effusion or thickening, similar. Shallow inspiration accentuates heart size, pulmonary vascularity, more prominent. Thoracic kyphosis. No infiltrates.
<unk> year old woman with fistulizing crohn's disease, pod#<unk> s/p i d of superficial abscess, placement of abdominal <unk>, now with fever // please evaluate for intrathoracic pathology
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Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. Given this, no definite focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Degenerative changes are again seen along the spine.
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There has been previous median sternotomy. Cardiac silhouette is enlarged, accompanied by pulmonary vascular engorgement and mild interstitial edema as well as a small right pleural effusion and probable small left pleural effusion.
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Left-sided port-a-cath tip terminates in the low svc. Heart size remains moderately enlarged. The aorta is tortuous. Dilation of the ascending thoracic aorta it is better assessed on the previous ct. Lung volumes are lower compared to the prior study with atelectasis noted in the lung bases. There is no focal consolidation, pleural effusion or pneumothorax identified. No definite pulmonary edema is present. Diffuse osseous metastatic disease is re- demonstrated with multiple compression deformities seen in the thoracic spine. Additionally, patient is status post right mastectomy with multiple calcifications seen within the right chest wall.
history: <unk>f with metastatic breast cancer presenting with lethargy and hypoxia
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The lung volumes are low. There is bilateral basal atelectasis. The left costophrenic angle is blunted, which may be secondary to atelectasis or a trace pleural effusion. There is no consolidation, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. Surgical clips are noted in the right upper quadrant.
epigastric and right upper quadrant pain.
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There are subtle nodular opacities in the lower lobes bilaterally. The cardiac contour is unremarkable. There is tortuosity of the thoracic aorta. There is no pleural effusion or pneumothorax.
history: <unk>m with cough and fevers, evaluate for pneumonia..
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In comparison with the study of <unk>, the monitoring and support devices remain in place. Continued consolidation in the left lung with probably a moderately decreased pulmonary edema. Opacification at the bases obscuring the hemidiaphragms is consistent with pleural effusion and compressive atelectasis at the bases. Substantial volume loss in the left lower lobe is identified.
pneumonia with intubation.
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Ap upright and lateral views of the chest provided. Low lung volumes cause bronchovascular crowding. There is no focal consolidation, effusion, or pneumothorax. There is mild right basilar atelectasis. Cardiomegaly is moderate. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Left chest cardiac device with lead tips in the right atrium and right ventricle is similar to prior. Left lower lobe nodule which contained coarse calcification on prior ct now appears larger.
history: <unk>f with s/p fall // eval for trauma nchct ich c spine fxs
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Compare with the prior radiograph, the right ij central line and nasogastric tubes have been removed, and the patient is now extubated. Left-sided chest tube is unchanged in position,, but there is evidence of a tiny left apical pneumothorax, with a pleural line projecting in the left third interspace. There is no associated mediastinal shift. Mediastinal drain again noted. No new focal consolidation. A left pleural effusion is small. Median sternotomy wires are intact. Cardiomediastinal silhouette is otherwise unchanged.
<unk> year old man s/p cabg w/air leak from chest tubes, now on water seal. evaluate for pneumothorax.
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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. Median sternotomy wires and an aortic valve prosthesis are noted.
history: <unk>m s/p <unk> with cough/cp symptoms. *** warning *** multiple patients with same last name! // pneumonia?
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There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities are identified. There is dextroconvex scoliosis of the upper thoracic spine.
<unk>-year-old female presenting for evaluation of left shoulder and back pain that has been present intermittently since <unk>. negative d-dimer.
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The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. Small left pleural effusion is noted with mild left basilar opacification likely reflecting atelectasis. The right lung is clear without evidence of a right-sided pleural effusion. No pneumothorax is present. There are no acute osseous abnormalities.
shortness of breath with known effusion.
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As compared to the previous radiograph, there is no relevant change. Mild cardiomegaly and evidence of mild-to-moderate pulmonary edema. Low lung volumes. No pleural effusions. No newly appeared focal parenchymal opacity suggesting pneumonia.
chronic heart failure, constipation, and vomiting.
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Portable ap upright chest radiograph was provided. Patient is quite rotated to his right which limits the evaluation of the lower lungs and mediastinum. Allowing for this, there is no definite evidence of pneumonia or chf. No large effusion or pneumothorax. The heart size appears stable. The mediastinal contour appears grossly unchanged. The bony structures are intact. Vascular calcifications project over the mediastinum.
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The patient is status post mitral valve replacement. A dual-lead pacemaker/icd device appears unchanged. The heart is mildly enlarged. The mediastinal and hilar contours appear unchanged. The lungs appear clear. Diaphragms are flattened suggesting hyperinflation. Mild-to-moderate degenerative changes along the lower thoracic spine appear similar.
fever. history of cancer.
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The lungs are clear. There is no consolidation or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities, no displaced rib fractures.
<unk>m with r sided chest/abd pain. // assess for infiltrate, pnthx
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Ap portable upright view of the chest. Hardware partially imaged in the lower t-spine. The lungs are clear. Mild elevation the right hemidiaphragm is unchanged. No large effusion or pneumothorax. No signs of congestion or edema. The heart and mediastinal contours are stable. Bony structures are intact.
<unk>m with behavioral changes
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Right pleural catheter has slightly changed in position compared to the prior study, but there is no substantial change in a small right pleural effusion. Multifocal cavitary lung lesions are again demonstrated as well as superimposed areas of consolidation in the mid and lower lungs. Interval abrupt worsening of opacity in the left lower lobe retrocardiac area could reflect worsening consolidation or superimposed atelectasis. Small left pleural effusion is unchanged.
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Pa and lateral chest radiographs were obtained. Multiple bilateral pulmonary nodules are similar in size and number to <unk>, but have increased since <unk>. There is no consolidation, effusion or pneumothorax. Right hilar enlargement is unchanged. No new abnormal cardiac or mediastinal contours.
cough.
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A portable frontal chest radiograph demonstrates low lung volumes, with resulting prominence of the cardiac silhouette and bronchovascular crowding. There is no focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable.
cough and fever. evaluate for pneumonia.
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There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.
history: <unk>f with cough and asthma exacerbation // please evaluate for pneumonia
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The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal.
<unk>-year-old woman presenting with palpitations and chest tightness.
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Blunting of the right costophrenic angle is new since the prior study, suggesting small right pleural effusion with overlying right base atelectasis. Additional basilar opacity could be due to atelectasis although consolidation due to infection or aspiration is not excluded in the appropriate clinical setting. There is persistent enlargement of the cardiac silhouette. Mediastinal contours are grossly stable. No overt pulmonary edema is seen.
history: <unk>f with sob // acute process
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No focal consolidation, pleural effusion or pneumothorax is present. Heart size, mediastinal and hilar contours are normal. Lungs remain stably hyperinflated with unchanged scarring at the apices. Moderate hiatal hernia is unchanged. Mild scoliosis is unchanged.
cough and low oxygen saturations in office today. decreased breath sounds at bases bilaterally, no wheeze, rales, rhonchi. evaluate for pneumonia versus effusion versus other cause.
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Heart size is normal. Mediastinal and hilar contours are unchanged with a prominent right-sided epicardial fat pad again noted. Pulmonary vascularity is normal and the lungs are clear. No pleural effusion, focal consolidation or pneumothorax is identified. There are no acute osseous abnormalities. Multiple clips are again noted projecting over the left chest wall and upper abdomen.
intermittent fever for <num> weeks
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Patient is status post median sternotomy and cabg. Heart size is mildly enlarged with a moderate hiatal hernia noted. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. Patchy opacities are seen in the lung bases, more pronounced on the left, worse in the interval, and may reflect superimposed aspiration on a background of chronic interstitial abnormality. No pleural effusion or pneumothorax is present. Compression deformity of the t<num> vertebral body is re- demonstrated. Fractures of the right fifth and sixth lateral ribs are again noted.
history: <unk>m with syncope
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There has been interval placement of a right internal jugular central venous catheter with the tip terminating at the level of the mid to lower svc. The course of the line is unremarkable. There is unchanged elevation of the right hemidiaphragm. Right basilar atelectasis is again seen. Blunting of the left costophrenic angle may represent a small left pleural effusion. No pneumothorax is detected. The cardiac silhouette is incompletely evaluated but appears enlarged. The mediastinal contours are within normal limits. There is prominence of the main pulmonary artery suggesting underlying pulmonary hypertension. Calcification of the aortic knob is noted.
right ij line placement, here to evaluate line position.
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Again seen is an intra-aortic balloon pump, the tip is <num> cm below the top of the aortic arch. The cardiomediastinal contour is unchanged. Persistent prominence of bilateral hila consistent with pulmonary vascular congestion. No overt pulmonary edema. No pneumothorax seen.
<unk> yom w/ pmh of cad (diagnosed on ett), hld, htn, hypothyroidism who recently presented to his private care doctor for abdominal complaints, found to have hemolytic anemia, developed stemi in ed, now s/p lhc showing <num>vcad. // iabp positioning
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Patient is rotated considerably to the right. Given this, interval placement of endotracheal tube is seen, terminating approximately <num> cm above the level of the carina. Enteric tube courses below the level of the diaphragm into the left upper quadrant, presumed terminating in the stomach, with side port at the level of the ge junction. The cardiac and mediastinal silhouettes are grossly stable given differences in patient position, with the cardiac silhouette enlarged. There is persistent blunting of the right costophrenic angle. Vascular prominence appears stable to possibly minimally decreased. Chronic appearing left rib deformities are noted.
history: <unk>f with intubation, multifactorial shock // eval ett placement
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Frontal and lateral views of the chest were obtained. The patient is rotated with respect to the film. The heart is of normal size with normal cardiomediastinal contours. Pulmonary vasculature is unremarkable. Lungs are clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. No radiopaque foreign body. Right clavicle midshaft fracture is better evaluated on accompanying dedicated right clavicle films.
status post fall after bike accident. evaluate for fracture or pneumothorax.
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Median sternotomy wires intact and aligned. Ng tube extends into the stomach. Endotracheal tube ends <num> cm above the carina. Left swan-ganz catheter ends in the pulmonary artery. Right large-bore catheter ends in the right atrium. New pulmonary vascular congestion without pulmonary edema. New, small right pleural effusion and atelectasis. Unchanged, large scale atelectasis in the left lower lobe. Increased, moderate left pleural effusion. Decreased, minimal pneumopericardium. Expected postoperative cardiomediastinal silhouette. No pneumothorax.
<unk>-year-old woman status post aortic valve replacement. evaluate for infiltrate or pleural effusion
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A single frontal radiograph demonstrates an endotracheal tube appropriately positioned approximately <num> cm above the carina. Lung volumes are low and there is minimal pulmonary vascular engorgement. A nasogastric tube terminates within the stomach. The lungs are clear. There is no pneumothorax or pleural effusion. Cardiomediastinal contours are normal.
evaluate position of endotracheal tube following intubation.
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The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. Bronchial wall thickening is likely related to chronic airway inflammation and has been more fully evaluated on recent ct. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation worrisome for pneumonia.
history: <unk>m with cough // r/o pna
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There are are extensive pulmonary opacities, right greater than left, with differential diagnosis including asymmetric noncardiogenic pulmonary edema, massive aspiration, multifocal infection, pulmonary hemorrhage. No pleural effusion is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with found down, altered, hypoxic //
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Ap single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study of <unk>. The findings are completely unaltered. The previously described parenchymal densities with spontaneous air bronchogram in the right upper lobe area remains fully unchanged. No evidence of new pulmonary abnormalities and unchanged position of left-sided subclavian approach central venous line.
<unk>-year-old female patient with metastatic renal cell carcinoma, white blood count <unk>,<num>, recent pneumonia, check for interval change.
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As compared to the previous image, third above catheter has been advanced. The course of the catheter is unremarkable, the tip is not included on the image and, thus, located be low the gastroesophageal junction. The right picc line is unchanged. No pneumothorax.
<unk> year old man with alcoholic hepatitis with slight dislodgement of dobhoff tube // ? dobhoff placement
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Dual lead left-sided pacemaker is seen with lead extending the expected positions of the right atrium and right ventricle. The cardiac silhouette remains mildly enlarged. The aorta is tortuous. Mild prominence of the hila may be due to central pulmonary vascular engorgement. There is mild pulmonary vascular congestion. No focal consolidation is seen. There is no pleural effusion or pneumothorax.
history: <unk>f with chest and back pain // cardiac workup
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Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax.
confusion.
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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 chest is hyperinflated. The lungs appear clear. A small density projects above the distal right clavicle, possibly an object lying outside of the patient, although small soft tissue calcification might be possible.
chest pain.
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Single ap upright portable view of the chest was obtained. There is interval placement of a right-sided chest tube. Right-sided pneumothorax is no longer well apparent, decreased in the interval. Right base atelectasis is again seen along with elevation of the right hemidiaphragm. Subcutaneous emphysema along the right-sided chest wall and tracking in the right supraclavicular region is partially imaged. Left lung is clear. No large pleural effusion is seen. Cardiac and mediastinal silhouettes are stable and unremarkable.
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Subtle bibasilar opacities seen on the frontal view, not substantiated on the lateral view, may be due to atelectasis and overlying vascular structures although a residual pneumonia is not excluded in the appropriate clinical setting. Comparison with prior would be helpful for further evaluation in this patient reportedly being diagnosed with pneumonia at an outside facility. No pleural effusion or pneumothorax is seen. There is no pulmonary edema. Aortic knob calcification is seen. The cardiac silhouette is not enlarged. There is moderate to severe compression deformity of a mid thoracic vertebral body of indeterminate age. Correlate clinically and for acuity.
elevated white count, cough, copd. reports being diagnosed with pneumonia at an outside facility.
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Pa and lateral chest views were obtained with patient in upright position. Poor inspirational effort explains high position of diaphragms obscuring lung bases and lower half of cardiac contours. Crowded appearance of basal pulmonary vasculature is noted. There is mild blunting of the left lateral pleural sinus, but the right lateral pleural sinus is free. No evidence of acute pulmonary parenchymal infiltrates are seen. No pneumothorax exists in the apical area. The lateral view confirms the left-sided pleural effusion with moderate blunting of the posterior pleural sinus. The right lateral pleural sinus is free. When comparison is made with the next preceding portable chest examination of <unk>, the patient had remarkable high positioned diaphragms as well which was not unexpected in this patient with clinical history of acute pancreatitis. At that time, the chest examination demonstrated the presence of a right-sided picc line. This line remains visible on today's examination, and the line is seen to terminate in the lower third of the svc.
<unk>-year-old male patient with fever and right lower lobe rales. evaluate.
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The lungs are well inflated and clear. The cardiomediastinal silhouette is unremarkable. Hilar and pleural surfaces are normal.
history: <unk>m with cp // r/o pna. ptx
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The moderate left pleural effusion is unchanged. Prominent interstitial lung markings in the left lung are also unchanged, and remain concerning for lymphangitic spread of metastasis. Left-sided volume loss is unchanged. The right lung remains clear. There is no pneumothorax. The heart and mediastinum cannot be accurately assessed.
<unk> year old man with l sided effusion, likely malignant and pericardial effusion with tamponade physiology // interval change
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As compared to the previous radiograph, no relevant change is noted. Left lower lobe atelectasis, potentially combined to a small left pleural effusion. Normal size of the cardiac silhouette. Minimal fluid overload but no overt pulmonary edema. The nasogastric tube and the right picc line are in constant and unchanged position.
rhonchi, questionable pneumonia.
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Frontal and lateral views of the chest were obtained. There has been interval placement of a right-sided port-a-cath, terminating in the distal svc. The cardiac and mediastinal silhouettes are stable, with the aorta calcified and tortuous and the cardiac silhouette not enlarged. There are relatively low lung volumes which accentuate the bronchovascular markings. Medial right infrahilar opacity is felt to be due to vascular structures. Mild bibasilar atelectasis. No pleural effusion or pneumothorax.
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The patient is rotated to the left. Dual lead left-sided pacemaker is seen with leads extending to the expected positions of the right atrium and right ventricle. There is medial left upper lobe opacity worrisome for consolidation. Bibasilar atelectasis is seen. Possible medial right upper lobe atelectasis/ scarring. There may also be trace bilateral pleural effusions. Chronic underlying interstitial prominence is again seen. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are grossly stable given differences in patient positioning. The diaphragm activity right-sided pacer obscures the right lung base.
copd, hypoxia, cough.
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The cardiac silhouette is again severely enlarged with globular appearance that may suggest some degree of pericardial effusion. Extent of the heart size is difficult to evaluate in the presence of large bilateral pleural effusions which are similar in severity compared to prior exam, with adjacent bibasilar compressive atelectasis. There is increased central pulmonary vascular congestion with increased reticulations compatible with mild-to-moderate pulmonary edema. Calcified right lung nodules indicate prior granulomatous disease. There is no pneumothorax.
increasing shortness of breath.
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Single supine portable ap view of the chest was provided. The endotracheal tube is seen with its tip residing approximately <num> cm above the carina. A left arm picc line is seen with its tip in the mid svc. Ng tube courses inferiorly along the thoracic midline extending into the left upper quadrant. The heart appears mildly enlarged. Lower lobe opacities likely reflect atelectasis. The mid to upper lungs appear well aerated. The mediastinal contour is widened, though this is likely due to position. The bony structures are intact.
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The patient is status post sternotomy. The cardiac, mediastinal and hilar contours appear unchanged. The heart is at the upper limits of normal size. Patchy left lateral basilar opacities suggest minor atelectasis that is unchanged. There is a newly apparent round nodular opacity projecting over the right lung apex measuring about <num> mm in diameter. Although the area is difficult to evaluate due to overlapping bony structures, and it is known that scarring is present in the area from a prior ct of the cervical spine, the possibility of superimposed pulmonary nodule cannot be excluded by this study. There is no pleural effusion or pneumothorax. Small osteophytes are similar along the thoracic spine.
lightheadedness.
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Comparison is made to prior study from <unk>. Since the previous study, there has been placement of a pigtail catheter with the distal tip at the right base. There has been re-expansion of the right lung and no residual pneumothorax is seen. There is a persistent small right pleural effusion and some atelectasis. The heart size is enlarged. There is atelectasis at the left base as well. Median sternotomy wires and left-sided pacemaker are unchanged in position.
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The heart is again at the upper limits of normal size. The aortic arch is partly calcified. The mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. A new band-like opacity projecting over the left mid lung suggests minor atelectasis or scarring in the lingula. Otherwise, lungs remain clear. The bony structures are unremarkable.
cough. question pneumonia.
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Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. Single-lead right-sided pacemaker is again seen, unchanged in position. The cardiomediastinal silhouette remains enlarged, likely grossly stable given differences in inspiration. There is mild prominence of the pulmonary vasculature suggesting mild interstitial edema. It is difficult to exclude a right small pleural effusion due to overlying soft tissue partially obscuring the right costophrenic angle. Deformity of the posterior right seventh rib is compatible with prior fracture.
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Ap upright and lateral chest radiograph demonstrates clear lungs bilaterally. There is no pleural effusion. A dilated or tortuous descending aorta is noted. Cardiomediastinal and hilar contours are otherwise unremarkable. No evidence of over pulmonary edema. Osseous structures demonstrates no acute abnormality.
<unk>-year-old male with fever.
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Low lung volumes are present. The heart size is mildly enlarged. Mediastinal and hilar contours are unremarkable. There is mild pulmonary vascular congestion. Streaky bibasilar airspace opacities are likely reflective of atelectasis. No pleural effusion or pneumothorax is seen. Clips are noted within the left upper quadrant of the abdomen. No acute osseous abnormalities are noted.
tachycardia with recent cholecystectomy.
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An endotracheal tube ends approximately <num> cm above the carina. Lungs are grossly clear. Cardiomediastinal and hilar contours are unchanged. There is no pneumothorax or large pleural effusion. Mild pulmonary edema is seen. There is a contour irregularity of the inferior humeral head on the left, likely representing a reverse hill-<unk> deformity.
<unk>-year-old male, intubated on transfer, evaluate for et tube positioning..
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As compared to the previous radiograph, the right internal jugular vein catheter and the left internal jugular vein catheter are in unchanged position. There is no pneumothorax. The nasogastric tube is also unchanged, with the sidehole approximately <num> cm below the gastroesophageal junction and the tip not included on the film. Moderate cardiomegaly persists. No pleural effusions. No pulmonary edema.
central line placement.
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Frontal and lateral views of the chest are obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable.
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Since prior, there has been increased interstitial markings diffusely with pulmonary vascular congestion, compatible with worsening pulmonary edema. A more focal right medial basilar opacity is also present. The cardiomediastinal silhouette is unchanged. There is no large pleural effusion. There is no pneumothorax.
<unk> year old woman with urosepsis, worsening sob, evaluate for pulmonary edema..
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Heart size is normal. Mediastinal and hilar contours are unremarkable. Mild atherosclerotic calcifications are noted at the aortic knob. Pulmonary vasculature is normal. Lungs are hyperinflated without focal consolidation, pleural effusion or pneumothorax. Pleural-parenchymal scarring is noted at the apices bilaterally. There are no acute osseous abnormalities.
history: <unk>f with syncopal episode, bilateral crackles on auscultation
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Pa and lateral views of the chest provided. There is no focal consolidation. The pulmonary vasculature is normal. Heart size is normal. Mediastinal and hilar contours are normal. There is no pleural effusion. There are no fractures seen. A small granuloma is noted in the lower thoracic vertebral body.
<unk> year old woman with hx aml with right chest pain with movement, evaluate for fractured rib
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The cardiac silhouette size is normal. Aorta is mildly unfolded. Mediastinal and hilar contours are otherwise unremarkable. The pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities.
cough, elevated blood pressure with acute onset back and chest pain.
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The lungs are clear focal opacities concerning for infection. There is no evidence of pneumothorax or pulmonary edema. Blunting of the left costophrenic angle is chronic related to scarring as seen on the prior ct from <unk>. The right costophrenic angle is clear. Numerous surgical clips in the abdomen are imaged. The heart size is normal.
history: <unk>m with chest pain, etoh withdrawal // ? r/o intrathoracic process, chest pain //history: <unk>m with chest pain, etoh withdrawal
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The heart is not enlarged. Mild prominence the main pulmonary artery is within normal limits. There is slight upper zone redistribution, but no overt chf. No focal infiltrate, effusion, or gross pneumothorax is detected. Lateral view suggest possible minimal blunting of both costophrenic angles. No free air seen beneath the diaphragm.
<unk> year old woman with pancreatitis, now with hypoxia // please eval for pna, effusion, edema
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Support and monitoring devices are in standard position. Cardiomediastinal contours are stable. Slight improvement in widespread bilateral pulmonary opacities with upper and mid lung predominance. No substantial change in bilateral pleural effusions and/or thickening.
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Pigtail pleural catheter remains in place in the lower left hemithorax, with persistent moderate left pleural effusion and no visible pneumothorax. Overall improved aeration in left retrocardiac region, likely due to improving atelectasis, but worsening right lower lobe atelectasis and/or consolidation. Persistent small right pleural effusion.
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Pa and lateral views of the chest were compared to previous exam from <unk>. The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old male with chest pain intermittently for two weeks.
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Heart size is within normal limits. The cardiomediastinal silhouette is unchanged. Atelectasis is noted at the right lung base. An opacity at the left lung base could represent atelectasis, however pneumonia cannot be excluded.
<unk> year old man with tachycardia and relatively low oxygenation and disseminated zoster please eval for pneumonia // eval for pna or pulm edema
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There is streaky bibasilar opacity, similar to prior. Lung volumes are relatively low but they are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m with hypoxia and nonproductive cough // ?copd exacerbation
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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. Posterior left rib deformities are old. There is no visualized acute fracture.
<unk>-year-old male with pain, diminished lung sounds, status post assault. question fracture.
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Clips in the right axilla are unchanged in position. There is mild demineralization of the thoracic spine, but no vertebral compression fractures. There are no visualized rib fractures. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal.
history of left breast cancer with pain in the left upper back. evaluate for rib fracture, bone lesions.
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In comparison to chest radiograph earlier today, bibasilar consolidation persists, more likely pneumonia than dependent pulmonary edema because pulmonary and mediastinal vessels are not engorged. Median sternotomy wires are well aligned. Left pleural scarring and mid lung atelectasis are unchanged over at least three weeks, and may be post surgical. Mild cardiomegaly is stable . Healed right posterolateral rib fractures are longstanding..
evaluation of patient with shortness of breath at outside hospital improved with lasix for pulmonary edema.
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The cardiac silhouette is prominent. The central pulmonary vasculature appears engorged, the more distal vasculature is appears more defined. There is no pleural effusion or pneumothorax. Minimal right infrahilar opacity is noted, not significantly changed since <unk>. In the appropriate clinical context, this may represent pneumonia.
<unk> year old woman with fever post-op // eval for possible pneumonia
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Chest, ap and lateral. The opacity seen on the prior radiograph in the right lower lobe has minimally worsened. The upper lungs are clear. A small left pleural effusion is unchanged. Cardiomegaly is chronic. There is mild pulmonary edema. The patient is status post mitral valve replacement and cabg. There is no pneumothorax.
fever and recent admission for pneumonia.
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The lungs are clear without consolidation. Cardiac silhouette is within normal limits for technique. No acute osseous abnormalities.
<unk>f with waxing/waning altered mental status // ?ich, ?pna
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No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The lungs are noted to be mildly hyperexpanded, compatible with mild chronic obstructive pulmonary disease. The cardiomediastinal silhouette is stable. No acute bony abnormality is detected.
chest pain status post cocaine use.