ChayanM/MIMIC-MultiView-Findings-Query_Optional

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The heart size, mediastinal, and hilar contours are normal. The lungs are clear without pleural effusion, focal consolidation, or pneumothorax.small well-circumscribed rounded lucency overlying the proximal left clavicle is possibly a small bone cyst.

<unk>m who had a bike accident today with pain on shoulder movement and point tenderness over clavicle. fracture?

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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. Marker indicating the site of patient's tenderness is noted at the level of the left ninth rib laterally. No acute osseous abnormalities are seen in the vicinity of this marker.

history: <unk>f with rib pain

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Pa and lateral views of the chest demonstrate unchanged position of pacemaker leads, terminating in the right atrium and the right ventricle. Within the right lung, multiple nodular and branching opacities are identified, which could represent a component of bronchiectasis, although not present previously, and also could be multifocal pneumonia in the appropriate clinical setting. Additionally, there is mild prominence of the right hilar structures, possibly representing lymphadenopathy or vascular structures. There is no pleural effusion or pneumothorax.

<unk>-year-old male with hepatic and renal failure.

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Compared with prior radiographs on <unk>, there has been interval placement of a left-sided chest tube, ett and nasogastric tube, as well as removal of a right ij catheter. The nasogastric tube terminates above the left hemidiaphragm, possibly in a previously seen hiatal hernia. The et tube is appropriately positioned. There is no pneumothorax. A right layering pleural effusion and atelectasis are similar to prior.

<unk> year old woman with hypotension and shock, ngt above diaphragm on recent imaging, now advanced // eval for ngt placement

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Frontal and lateral views of the chest. Severe pulmonary edema is present with moderate sized bilateral pleural effusions and adjacent lower lobe opacities which could represent either infection or atelectasis. Effusions obscure the cardiac borders but there is at least mild cardiomegaly. No pneumothorax.

shortness of breath.

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Single ap view of the chest was reviewed. Since the recent prior study less than one hour prior, there has been introduction of an endotracheal tube with tip terminating <num> cm above the carina. There has been no significant change in the remainder of the radiograph.

intubation.

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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. No free air below the right hemidiaphragm is seen.

<unk>m with l knee infection s/p quad tendon repair // surgrey pre-op

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Pa and lateral views of the chest provided. Elevated right hemidiaphragm again noted with associated right basal atelectasis. There is no focal consolidation concerning for pneumonia. No edema, large effusion or pneumothorax. The overall cardiomediastinal silhouette appears unchanged though the right heart borders partially obscured. Bony structures appear intact. Anchors are seen imbedded within the right glenoid fossa.

<unk>m with elevated lactate, infectious workup

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Heart size is top normal. The aorta remains mildly tortuous. Mediastinal and hilar contours are normal otherwise. Lungs are clear and the pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized.

history: <unk>f with seizure

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New pulmonary edema is mild. Pleural effusion is small, if any. There is no pneumothorax.

desaturation to <unk>% and crackle, rule out fluid overload.

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Lung volumes are mildly decreased with bibasilar opacities likely reflective of atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size.

<unk>-year-old male with syncope. evaluate for pneumonia.

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Et tube, ng tube, right and left ij lines, and left chest tube are similar in configuration. Sternotomy wires are present, with a gap again noted between the second and third wires. A prosthetic valve is also present, likely an aortic valve. The cardiac silhouette is moderately severely enlarged, similar to prior. Increased retrocardiac opacity compatible with left lower lobe collapse and/or consolidation is similar to the prior film. The left-sided effusion is slightly smaller. Additional pleural fluid and/or thickening is again noted at the left lung apex. There is chf, which appears increased compared with the prior film. Hazy opacity at the right lung base is increased, consistent with a slightly larger right pleural effusion and underlying collapse and/or consolidation. Linear lucency along the right chest wall more likely relax her relates a skin fold, but a lateral sided pneumothorax could have a similar appearance.

<unk> year old man s/p left ct placement // eval left effusion

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Lungs are relatively hyperinflated with the cardiac silhouette appearing slightly smaller as compared the prior study. Mediastinal contours unremarkable. No overt pulmonary edema. No focal consolidation, large pleural effusion or pneumothorax. Subtle streaky left base retrocardiac opacity is likely atelectasis and overlap of vascular structures. Right-sided central venous catheter terminates in the low svc. Tracheostomy tube is re- demonstrated.

history: <unk>m with dyspnea, trach // eval for acute process

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There is no consolidation or pneumothorax. Mild blunting of the left costophrenic angle is consistent with a small left pleural effusion as demonstrated on outside neck ct. No evidence of pneumomediastinum is identified. Heart is normal size. Soft tissue swelling is noted in the left supraclavicular region, and note is made of widening of the left superior mediastinal contour, both more fully evaluated on the neck ct exam.

history: <unk>f with ?pneumonmediastinum // int change?

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The heart is mildly enlarged. The mediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation.

<unk>-year-old woman with altered mental status, evaluate for pneumonia

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There is no lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is unchanged in appearance.

history: <unk>f with cough // r/o acute process

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Comparison is made to the prior radiograph performed three hours earlier. There is a fracture plate fixating a fracture of the mid clavicle. Several displaced left-sided rib fractures are again seen. There are no signs for focal consolidation or pneumothoraces. The scapular fracture is again noted. No pulmonary edema is seen.

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The cardiomediastinal silhouettes are normal. The bilateral hila are normal. Subtle opacities at the lung bases are compatible with minimal dependent atelectasis. The lungs are hyperinflated. Otherwise, there are no focal lung consolidations. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or effusion.

history: <unk>m with ruq pain // ?cholecystitis

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Marked cardiomegaly is stable in appearance. Pulmonary vascular congestion has improved, and pulmonary edema has nearly resolved with minimal residual interstitial edema remaining. Interval improved aeration in left lower lobe with residual patchy and linear atelectasis remaining. Right retrocardiac opacity appears similar and also likely represents atelectasis. Bilateral small pleural effusions are also demonstrated.

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Ap portable upright view of the chest. Overlying ekg leads are present. Numerous surgical clips project over the left upper abdomen. Volume loss in the left lung likely reflect prior wedge resection given suture material in the left suprahilar region. There is no free air below the right hemidiaphragm. Lungs appear clear allowing for chronic scarring in the left lung from prior surgery. Cardiomediastinal silhouette is stable. No large effusion or pneumothorax. Left ribcage deformity again noted from prior wedge resection.

<unk>m with vomiting blood after eating lamb. epigastric ttp

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Single portable frontal chest radiograph demonstrates grossly clear lungs. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits.

hypertension. assess for pneumonia.

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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Coronary artery calcification or stenting is seen. There is a partially imaged ivc filter.

history: <unk>f with h/o renal transplant p/w <num>mo malaise and nausea x<num> week // evaluate for pna

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Interval advancement of nasogastric tube, with side port now advanced from the lower esophagus into the stomach. Exam is otherwise similar to the prior study except for slight worsening of linear bibasilar atelectasis. Distended loops of bowel in imaged upper abdomen are incompletely evaluated, but have been more fully characterized on recent ct demonstrating findings of small bowel obstruction.

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Sternotomy. Et tube tip is satisfactory. There is diffuse haziness throughout both lung fields along with prominent vessels. Findings suggest congestive heart failure as well as pleural effusions. No focal consolidation is identified.

shortness of breath.

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The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. Lower thoracic interspaces are mildly narrowed with mild sclerotic endplate changes. There has been no significant change.

headache and vision changes.

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Ap and lateral chest radiograph demonstrates bilateral opacities better appreciated on recent dedicated chest ct dated <unk> consistent with lung nodules. The largest opacity within the left lower lobe is best demonstrated on the lateral radiograph which measures approximately <num> cm in diameter. Low lung volumes accentuate the cardiac silhouette and result in crowding of bronchovascular structures, particularly at the bases. Attenuation of upper lobe vessels corresponds to emphysema on recent ct. There is no evidence of pulmonary edema, pleural effusion, or pneumothorax.

history: <unk>m with doe // pulmonary edema or pneumonia?

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The endotracheal tube ends <num> cm above the level of the carina. A right internal jugular central venous catheter ends in the mid svc. A large-bore left subclavian central venous catheter ends in either the distal left subclavian vein or proximal left brachiocephalic vein. An enteric catheter courses below the level of the diaphragm, ending in the mid stomach. A left pleural catheter ends at the left lung base. Two presumed abdominal drains are noted over the left upper abdominal quadrant. Multiple surgical clips are seen in the right upper abdominal quadrant. Lung volumes are slightly low. There is minimal left retrocardiac atelectasis. The lungs are otherwise clear. The heart size is normal. The mediastinal contours are normal. There are no definite pleural effusions. No pneumothorax is seen. Note is made of multiple bilateral old rib fractures, as seen on the prior radiograph from <unk>.

status post abdominal surgery. assess lines/tubes and evaluate for pneumonia, and assess fluid status.

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Lower lung volumes seen on the current exam and there is crowding of the bronchovascular markings. Bibasilar opacities are identified. There is no large effusion. The cardiomediastinal silhouette has not definitely changed. No acute osseous abnormalities identified.

<unk>f with cp, sob, with radiation to the back // ? pna, dissection

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Pa and lateral views of the chest were provided. The heart appears mildly enlarged. There is no overt edema. No large effusion or pneumothorax. No focal consolidations suggestive of pneumonia. Bony structures are intact. No free air below the right hemidiaphragm.

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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 ams, cough

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Moderate cardiomegaly has been stable compared to the exam from <unk>. There has been interval worsening of moderate pulmonary edema, as well as interval development of an asymmetric right perihilar opacity. Mild bibasilar atelectasis is persistent. There are small bilateral pleural effusions. There is no pneumothorax. The visualized osseous structures are unremarkable.

history of dyspnea. please evaluate for pulmonary edema.

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As compared to prior chest radiograph from <unk>, there has been slight improvement, with increased aeration of upper lobes. Bibasilar atelectasis with small pleural effusions are stable. Mediastinal and cardiac contour enlargement is unchanged. Tracheostomy and left-sided defibrillator in the right ventricle are in adequate position.

<unk>-year-old male patient status post pea arrest and status post rewarming, now intubated on trach. study requested for evaluation of interval change.

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The et tube, ng tube, and right ij line have been removed. The dual-lead pacemaker is still in place. There continues to be moderate cardiomegaly. There is dense retrocardiac opacity consistent with volume loss/infiltrate/effusion. There is a small right effusion as well and low lung volumes in the right lower lobe. Compared to the prior exam, the effusions are left greater than right and the amount of retrocardiac opacity is increased.

status post avr, cabg, pneumothorax.

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Biapical linear and nodular opacities are present, with adjacent relatively symmetrical biapical thickening and mild associated upper lobe volume loss. Lungs are otherwise clear except for focal linear scar or atelectasis at the left base. Heart size, mediastinal and hilar contours are normal, and there are no pleural effusions. Mild scoliosis is noted.

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Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal.

<unk>f with cough // evaluate for pneumonia

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Ap single view in upright position shows stable position of the right subclavian picc with tip ending in the upper svc. Moderate lung volume is normal without consolidation or nodules suspicious for infection or malignancy. Linear atelectsis is at the left lung base. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax.

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The lungs are clear. The cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax.

<unk>-year-old with accident.

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There is persistent mild elevation of the right hemidiaphragm. Minimal bibasilar atelectasis is seen. There is no focal consolidation. The cardiac and mediastinal silhouettes are stable and unremarkable. Hilar contours are stable. Evidence of prior rib deformities/fractures are seen involving at least the right posterior fourth and fifth ribs, stable as compared to prior.

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A portable upright radiograph of the chest demonstrates atelectasis of the right lung base but otherwise clear lungs. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal.

chest pain.

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An endotracheal tube appears unchanged. A right subclavian central venous catheter terminates in the upper superior vena cava. An orogastric tube terminates near the pylorus, probably within the antrum, less likely but potentially the proximal duodenum. There is patchy opacification obscuring the left hemidiaphragm with a suspected pleural effusion, potentially atelectasis versus pneumonia. In addition, a right infrahilar opacity appears slightly more prominent, although apparent change may be due to differences in technique. Aspiration could also be considered as a possible etiology, noting the history.

status post recent subarachnoid hemorrhage and aneurysm coiling with intubation for airway protection, presenting with new fever.

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There is mild bibasilar atelectasis; otherwise, the lungs are clear with no evidence of consolidation or effusion. There is no pneumothorax. Cardiomediastinal silhouette remains moderately enlarged but stable. Two-lead pacemaker appears in place.

altered mental status.

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No definite et tube is identified. Tubing is folded over the upper airway. At, but could lie outside the patient or could be related to the ng tube. Clinical correlation is required. An ng tube is present -- the tip extends beneath the diaphragm loops over the expected site of the fundus. A swan-ganz catheter is present, tip over proximal right pulmonary artery. A left subclavian central line is present, tip not well delineated, but likely over the distal svc. No pneumothorax is detected. Left-sided battery device is again seen, with lead extending cephalad over left neck, beyond the edge of this film. There are low inspiratory volumes. There is dense retrocardiac opacity, consistent with left lower lobe collapse and/or consolidation. There is also patchy opacity at the right lung base. No gross effusion.

<unk> year old man with status epilepticus, now intubated // eval for interval change

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There is left lower lobe consolidation. Biapical scarring is noted. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. Anterior cervical fixation hardware is partially visualized. Lower thoracic levoscoliosis is identified.

<unk>f with report of pneumonia s/p treatment still symptomatic // evidence of intrapulmonary process

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In comparison with the earlier study of this date, the tip of the opaque wire within the picc line extends only to the subclavian vein. There then is the suggestion of an ill-defined linear opacity that curls downward toward the region of the superior portion of the svc. However, it is unclear whether this represents a true catheter or merely a fortuitous combination of shadows. This information was telephoned to <unk>, the iv nurse, indicating that the apparent tip of the catheter would be the appropriate distance correlating with her evaluation of the relative position of the wire with the tip of the tube. However, it is impossible to be completely certain that this is the situation.

picc placement.

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In comparison with study of <unk>, there is little overall change. Cardiac silhouette is mildly enlarged with pacemaker device in place. No vascular congestion, pleural effusion, or acute focal pneumonia. There may be mild atelectasis in the retrocardiac region.

postoperative with gi bleed and transfusion, to assess for chf.

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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.

history: <unk>m with c/o cp // ? pna

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As compared to the previous radiograph, the patient has received a tracheostomy tube. The nasogastric tube remains in place, as does the right-sided picc line. The signs indicative of pulmonary edema have decreased. At the right lung base, plate-like atelectasis has newly appeared. Moderate cardiomegaly persists. No larger pleural effusions are visualized.

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As compared to the recent radiograph, there has been little overall change in the appearance of the chest except for removal of right internal jugular vascular sheath, with no evidence of pneumothorax, and slight improvement in the degree of left lower lobe atelectasis as well as minimal improved aeration at the right lung base. Focal left upper lobe opacity has been more fully characterized on recent ct of <unk>.

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In comparison with the study of <unk>, there is little change. Again there is elevation of the right hemidiaphragmatic contour with its peak somewhat laterally, consistent with subpulmonic effusion. No acute pneumonia or vascular congestion. A central catheter again extends to the mid to lower portion of the svc.

pleural effusion.

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There is no focal consolidation, pleural effusion or pneumothorax. There is likely mild bibasilar atelectasis. Cardiomediastinal contours are within normal limits. No acute osseous abnormalities are identified.

history: <unk>f with sob, dka // eval for pneumonia

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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable.

pre-operative.

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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 obtained two hours earlier during the same day. On the preceding examination, the dobbhoff line had barely entered the stomach in an unusual fashion in as much as the tip reversed towards the hiatus. On the present examination, the dobbhoff line is now more normally aligned with its tip pointing towards the body of the stomach. Dependent on intention where to place the line, further manipulations are required.

<unk>-year-old male patient with dobbhoff line adjustment.

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There are bilateral lower lobe infiltrates and increased lung markings throughout the lungs. There tiny bilateral effusions. There is volume loss in the lower lobes. The heart size is upper limits of normal.

<unk> year old woman with fevers and leukopenia. // please eval for pneumonia

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Pa and lateral views of the chest. No focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar contours are normal.

fevers, question pneumonia.

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The heart size is normal. The hilar and mediastinal contours are normal. No focal consolidations concerning for pneumonia are identified. Note is made of a trace left apical pneumothorax overall unchanged compared to the prior exam. There is no pleural effusion. The visualized osseous structures are unremarkable.

history: <unk>m with s/p vats for ln biopsy with l sided pleuritic cp and sob and fever.

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The et tube terminates approximately <num> cm from the carina. There is an og tube which traverses below the diaphragm with the tip out of view from this radiograph. The swan-ganz catheter appears to be in appropriate position. Again seen is moderate enlargement of the heart, overall stable compared to the prior exam. There appears to be slight interval increase in focal consolidation at the left lung base compared to the prior exam. The left upper and mid lung zones appear to be overall well aerated, unchanged compared to the prior exam. There has been slight interval improvement in the right lung field which is obscured by a moderate-to-large right pleural effusion. No evidence of pneumothorax.

history of hypoxia, pleural effusions, please evaluate for interval change.

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Heart size, mediastinal and hilar contours are within normal limits and without change. Lungs are clear, and there are no pleural effusions or acute skeletal findings.

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The heart is enlarged. Bipolar pacemaker with leads in the ra and rv. The aorta is tortuous. Pulmonary hila are prominent, but no frank edema is seen no pleural effusion or pneumothorax.

<unk> year old man with afib and r posterior pons stroke. now tachypnea and tachycardia. // pna

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Frontal and lateral views of the chest. There is no pleural effusion, pneumothorax or focal airspace consolidation. Slight obscuration of the cardiac apex is unchanged. Bilateral nipple shadows are noted. The heart size is normal. A small amount of calcification is noted within the aortic arch. The hilar structures are unremarkable. Biapical pleural thickening is unchanged from <unk>.

shortness of breath and right arm pain. evaluate for an infectious process.

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Again seen is a dual-lead pacemaker and a right ij line with tip at the cavoatrial junction. There are bilateral pleural effusions and volume loss in both lower lungs. There are some patchy areas of alveolar infiltrate that are slightly increased compared to the prior study. The overall impression is that of worsened fluid status.

shortness of breath.

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Pa and lateral views of the chest were reviewed and compared to the prior studies. A left port-a-cath ends in the mid svc. Linear opacities in the right lung base represent atelectasis; otherwise, the lungs are clear. There is no pulmonary edema, pleural effusion or pneumothorax. The heart size is normal and a clacified tortuous aortic contour is unchanged. Expansion and sclerosis of a few right lower ribs is consistent with the diagnosis of myeloma. In the thoracic spine severe vertebral body compression fractures of the t<num> and t<num> vertebral bodies are unchanged since <unk>, but are slightly worse compared to the radiograph of <unk>.

cough in a patient with multiple myeloma.

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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>. During the examination interval, the previously present pig-tail end drainage catheter on the right base has been removed. No pneumothorax has developed. Some small amount of pleural effusion blunts the lateral pleural sinus and results in some hazy appearance of the right lung base, but the amount of fluid is not likely to have increased significantly. On the left base, the amount of pleural effusion appears stable. No new parenchymal abnormalities are identified.

<unk>-year-old male patient status post chest tube removal, evaluate for possible pneumothorax and worsening effusion.

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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. There is a linear radiodensity projecting over the left neck seen only the frontal view.

<unk>f with lost crown status post mvc. evidence of tooth/crown in lungs

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Pa and lateral views of the chest were provided. There is no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. No bony abnormalities are seen. No free air below the right hemidiaphragm.

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Pa and lateral views of the chest are compared to previous exams dating back to <unk> with most recent from <unk>. When compared to most recent exam, there has been apparent interval increase in size and conspicuity of multiple bilateral pulmonary nodules, more numerous at the right mid lung and right lung base compared to prior. Increased density projecting over the right hilum, compatible with adenopathy as on prior. There is no large confluent consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.

<unk>-year-old female with chest tightness yesterday, now with left-sided numbness. per medical history, the patient has history of sarcoidosis.

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Comparison is made to previous study from <unk>. There is a left-sided pacemaker which is unchanged. The heart size is enlarged. There is again seen a <num> cm oval calcification in the left perihilar region. There is a persistent left retrocardiac opacity.

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There are streaky bibasilar opacities which are most likely due to atelectasis. There is no focal consolidation, effusion, or edema. Cardiomediastinal silhouette is stable. No acute osseous abnormalities.

<unk>f with epigastric pain + n/v // ro infectious, pe or cardiac process

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Et tube tip is <num> cm from the carina. Enteric tube passes below the inferior field of view. Low lung volumes are seen with secondary crowding of the bronchovascular markings. There is no confluent consolidation, large effusion or evidence of pneumothorax on this supine film. The cardiomediastinal silhouette is within normal limits for technique.

<unk>f with intubated s/p sah, bun <unk> creatine <num> // eval for ett placement eval for clot and anueryism

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Large layering bilateral pleural effusions are present, partially obscuring the mediastinal contour. There is moderate pulmonary vascular congestion with mild pulmonary edema. Nodular opacities in the left mid and upper lungs in the right upper lung may represent pulmonary nodules or superimposition of structures. There is no pneumothorax. A tracheostomy tube appears well positioned. Severe multilevel degenerative changes of the thoracic spine are noted.

<unk>f with sepsis, altered mental status, evaluate for pneumonia.

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Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable.

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Compared with the prior radiograph, no significant change in the degree of vascular engorgement and interstitial pulmonary edema, more severe on the left. It is difficult to decipher how much of these changes are due to chronic interstitial disease, as correlated with the ct torso from the prior day. The abnormally thickened/partially calcified pleura is unchanged, as is the right pacer/defibrillator, with continuous leads in the right atrium and right ventricle.

<unk> year old man with chf, tachypnea. evaluate for fluid overload, acute change.

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As compared to the previous radiograph, the nasogastric tube has been removed. Right internal jugular vein catheter is unchanged. Unchanged appearance of the cardiac silhouette. No pleural effusions. No evidence of fluid overload. No evidence of pneumonia.

shortness of breath, evaluation for fluid overload.

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A do lead pacemaker is unchanged in position compared to the prior study. The heart size appears enlarged even allowing for the projection. Lung volumes are within normal limits. There is diffuse prominence of the bronchovascular markings with apparent diffuse reticular opacities. The findings are more consistent with interstitial lung disease than acute infection although this could have a similar appearance. There are small bilateral pleural effusions.

history: <unk>f with ? lll pna from osh, ? worsening infection in r foot // ? pna? signs of osteo in foot

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Pneumomediastinum appears to be regressing. Moderate left pleural effusion has increased in size. The opacity adjacent to the left cardiac border likely represents atelectasis, but consolidation is not excluded. Small pneumothoraces persist bilaterally. Cardiomediastinal contours are stable.

<unk>-year-old woman with esophageal perforation, evaluate for interval changes.

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No focal consolidation is seen. There are relatively low lung volumes on the frontal view. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are unremarkable. No pulmonary edema is seen.

history: <unk>m with htn, lv strain presents with epigastric pain radiating to neck and jaw // cardiac workup

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Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. There is pulmonary edema with increased interstitial markings bilaterally. Blunting of the costophrenic angels is compatible with small bilateral pleural effusions. Atelectasis is seen at the right lung base, where there is asymmetric elevation of the right hemidiaphragm. No pneumothorax is seen. No radiopaque foreign body. Wedge deformity of a lower thoracic vertebral body is similar to prior.

<unk>-year-old female with shortness of breath and history of chf. rule out acute process.

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Pa and lateral views of the chest. The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormality is detected.

<unk>-year-old male with chest pain.

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Lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. No evidence of free air. No evidence of pneumothorax or pleural effusions.

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A right internal jugular catheter is again visualized, the tip is better localize now seen to be in the distal svc close to the cavoatrial junction. The dual lead pacemaker is unchanged in appearance. There are persistent bilateral pleural effusions with associated atelectasis, superimposed infection cannot be excluded. No pneumothorax seen.

<unk> year old woman with chf // position of the right ij line

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Lateral left lung and bilateral costophrenic angles are excluded from the field of view. Despite this limitation, there is new lucency over the inferior and lateral right lung. No definite pneumothorax. Mild pulmonary edema in the right upper and left lung. Interval intubation with endotracheal tube terminating <num> cm above the carina. Heart size and cardiomediastinal hilar silhouettes are likely unchanged.

<unk> year old man with cardiac arrest // ptx?

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Ap upright and lateral views of the chest were obtained. Dual-lead left-sided pacemaker is again seen with leads unchanged in position. There are low lung volumes, which accentuate the bronchovascular markings. Left bibasilar atelectasis is seen. No clear focal consolidation. No large pleural effusion or pneumothorax. There is mild elevation of the right hemidiaphragm. The cardiac silhouette is top normal. The aorta is calcified and tortuous. Mild pulmonary vascular congestion is seen.

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In comparison the most recent prior, there is significant improvement in left-sided pleural effusion. Linear bibasilar opacities are most consistent with atelectasis. The cardiac silhouette is enlarged. The pulmonary vasculature is unremarkable. A right-sided picc terminates in the mid to lower svc. Left bronchial stent appears to be in stable positions since prior examinations.

history: <unk>f with couch and hx of stent in l bronchus // eval for any evidence of pneumonia, eval stent

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Pa and lateral views of the chest. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. No free air seen below the diaphragm.

<unk>-year-old male with history of hcv, alcoholic cirrhosis and pancreatitis with abdominal pain.

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Ng tube tip terminates in the mid stomach. The stylet is visualized within the ng tube. This finding was called to dr. <unk> by dr. <unk> at <unk> on <unk>.

ng tube placement.

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In comparison with the outside study of <unk>, there are substantially lower lung volumes, which may account for some of the increased prominence of the transverse diameter of the heart. There is some fullness of pulmonary vessels, though again this could reflect low lung volumes or some mild element of elevated pulmonary venous pressure. Minimal atelectatic changes at the bases without evidence of acute focal pneumonia.

low platelet count with shortness of breath and brown sputum, to assess for pneumonia.

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Portable semi-upright radiograph of the chest demonstrates interval placement of a right-sided chest tube with subsequent significant improvement in large right-sided pleural effusion. A small persistent right-sided pleural effusion is present. No definite pneumothorax is identified. Right-sided atelectasis is present. No other change seen.

history: <unk>f with s/p pigtail // palcement

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The lungs are clear. The heart and mediastinal structures are unremarkable. The bony thorax is grossly intact.

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The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Focal patchy opacity in the left lung base is felt to reflect a confluence of shadows. Lungs are otherwise clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.

chest pain.

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The cardiac, mediastinal and hilar contours appear unchanged, allowing for differences in technique, including ap portable technique. There is no pleural effusion or pneumothorax. The lungs appear clear. A prior healed left clavicle fracture appears unchanged.

altered mental status and hypotension.

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The heart is at the upper limits of normal size. The aorta is mildly tortuous with calcification noted along the arch. Hilar contours are unremarkable. A small pleural effusion is suspected on the right, no definite one on the left. Streaky opacity along the left costophrenic angle suggests minor atelectasis or scarring. No parenchymal edema is convincingly detected. The bones appear demineralized.

congestive heart failure.

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Following removal of right chest tubes, there is no visible pneumothorax. Cardiomediastinal contours are stable. Bibasilar atelectasis is again demonstrated, slightly improved on the left and slightly worse on the right. Small pleural effusions are present.

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Cardiac silhouette remains enlarged but unchanged from prior study. Again appreciated is an intra-aortic balloon pump with the tip terminating <num> cm caudal to the aortic knob, in appropriate position. Bilateral widespread parenchymal opacities with perihilar predominance is slightly increased compared to prior study and has progressively increased since <unk> compatible with progressive pulmonary edema. Small bilateral pleural effusions are unchanged. There is no pneumothorax.

critical aortic stenosis with iabp placed two days ago.

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Portable ap upright chest radiograph obtained. There is a small right apical pneumothorax which is slightly diminished in size compared with outside hospital prior exam. No significant right lung collapse. A tiny fiducial seed is noted within a known right lower lobe nodular lesion, better seen on the prior ct. Cardiomediastinal silhouette is normal. No large effusion is seen. Bony structures are intact.

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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs are clear. There are no pleural effusions or pneumothorax. Mid thoracic interspaces are minimally narrowed.

cough and fever. question pneumonia.

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The cardiac, mediastinal and hilar contours appear stable. The patient is status post sternotomy and coronary artery bypass graft surgery. Native coronary arteries are heavily calcified and there may one or more stents as well. There is no pleural effusion or pneumothorax. The lungs appear clear.

chest, pa and lateral.

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Ap portable supine view of the chest. Et tube tip located <num> cm above the carinal. The orogastric tube extends inferiorly towards the diaphragm though the tip is not within the imaged field. Right chest wall subcutaneous emphysema is noted along the right rib cage raising potential concern for underlying rib fractures in the setting of prolonged cpr. No large right pneumothorax is seen. Cardiomediastinal silhouette is grossly unremarkable aside from calcified thoracic aorta. Lungs appear relatively clear.

<unk>m with arrest s/p cpr intubation

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Pa and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal.

cough and vomiting.

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Give ap technique and the low lung volumes, heart size is normal. Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. Lucency under the right hemidiaphragm is once again noted, compatible with pneumoperitoneum, expected in the setting of peritoneal dialysis.

productive cough and malaise for two days.

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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen.

history: <unk>m with chest pain, dyspnea // r/o chf

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The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal.

<unk>-year-old male with cough, shortness of breath and chest pain. evaluate for pneumonia.