itsanmolgupta/mimic-cxr-dataset-cleaned · Datasets at Hugging Face

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There has been interval removal of a left-sided PICC. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. A battery pack is seen overlying the medial left hemithorax. Cardiac and mediastinal silhouettes are stable. Surgical clips are seen in the upper abdomen.	No acute cardiopulmonary process.	6,913
Lung volumes are relatively low with left greater than right bibasilar opacities which are likely secondary to atelectasis. Superiorly, the lungs are clear. The cardiomediastinal silhouette is within normal limits. There is a comminuted proximal left humerus fracture with suggestion of callus formation.	Bibasilar opacities which are likely atelectasis. Comminuted proximal left humerus fracture, with suggestion of callus formation suggesting this is not acute but clinical correlation is suggested.	11,229
Right internal jugular central venous line terminates in the superior aspect of the right atrium. No evidence of pneumothorax. Significant bibasilar atelectasis is noted. Small bilateral pleural effusions are noted.	Right internal jugular central venous line terminates in the superior aspect of the right atrium. Significant bibasilar atelectasis.	11,236
Nasogastric tube projects over the esophagus and courses out of sight inferiorly. Right-sided IJV catheter in situ with the tip in the proximal SVC. The left upper lobe mass is again identified with mediastinal shift to the right. There has been new development of opacification of the left lower lobe with minimal residual aeration in the inferior aspect of the left lower lobe. The right lung is clear.	There is a new opacification of the left lower lobe, and I get the impression of volume gain suggesting airspace consolidation rather than atelectasis.	17,028
The left PICC line is malpositioned, terminating within the right brachiocephalic vein. The linear opacities within the left midlung likely represent atelectasis, although the previously visualized bibasilar atelectasis has significantly improved. There is mild vascular congestion, but no frank pulmonary edema. The cardiac silhouette is enlarged but stable. There are no large pleural effusions. There is no pneumothorax.	Malpositioned left PICC line within the right brachiocephalic vein. Mild vascular congestion. Improved bibasilar atelectasis.	13,837
The moderate left effusion appears unchanged. There is likely a new small right pleural effusion. The enteric tube passes below the diaphragm and outside of the field of view within a decompressed stomach. The left-sided PICC line ends in the high SVC. There is mild pulmonary vascular congestion without frank pulmonary edema. There is no focal consolidation or pneumothorax. The cardiomediastinal silhouette is within normal limits.	New small right pleural effusion. Mild volume overload.	3,906
The heart size is normal. The hilar and mediastinal contours are normal. A tracheostomy tube is seen in place. There is a well-circumscribed rounded opacity along the medial left lung base which appears more prominent, compared to the prior exam. There is no evidence of a pneumothorax. The bones are diffusely osteopenic, which are otherwise unremarkable.	Rounded opacity at the left lung base appears more prominent compared to the prior exam. This raises concern for diaphragmatic herniation or possibly rupture. Further imaging evaluation with CT may be helpful. No evidence of pneumonia.	19,838
Portable semi-upright radiograph of the chest demonstrates well expanded lungs. There is bibasilar atelectasis without definite consolidation. Minimal left pleural effusion. Mediastinal and hilar contours are unremarkable. There is no pneumothorax.	Bibasilar atelectasis without definite consolidation.	10,884
AP portable supine view of the chest. Dual lead pacer is noted with pacer pack projecting over the left chest wall and leads extending to the region of the right atrium and right ventricle. Predominately left-sided calcified pleural plaque is noted likely accounting for the opacity projecting over the lateral aspect of the left lower lung. Evaluation for a subtle pneumonia in this area is therefore limited. Otherwise, no signs of pneumonia. No supine evidence for effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Chronic right rib deformities are noted involving the fourth, fifth, sixth, seventh, eighth, and ninth ribs.	Chronic right rib cage deformities. Calcified pleural plaque. Pacemaker in appropriate position. If there is strong clinical concern for an acute fracture, recommend dedicated rib series with a BB marking the site of maximal pain.	4,985
Right-sided Port-A-Cath tip terminates in the SVC. The heart size is normal. Mediastinal and hilar contours are unchanged. There has been interval improvement in aeration of the left lung base. A small left pleural effusion is likely present. Persistent partially loculated small to moderate right pleural effusion is unchanged with adjacent right basilar opacity likely reflecting compressive atelectasis. No pulmonary edema or pneumothorax is identified.	Interval improvement in aeration of the left lung base. Bilateral pleural effusions, right greater than left, relatively unchanged. Right basilar opacity likely reflects compressive atelectasis though infection cannot be completely excluded.	403
Heart size is normal. The aorta is slightly unfolded. The pulmonary vasculature is normal. Hilar contours are normal. Subsegmental atelectasis is noted in the right lung base. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities detected.	Subsegmental right basilar atelectasis.	8,130
There is a right central venous line that ends at the cavoatrial junction. The heart size is normal, and the patient is status post median sternotomy. There is bibasilar opacities reflecting fibrosis as noted on the dedicated chest CT. There is no pleural effusion or pulmonary edema.	Pulmonary fibrosis including in the right upper lobe is better assessed on the dedicated chest CT.	16,727
Stable right-sided Port-A-Cath in the mid SVC. Left PleurX catheter also in similar configuration. Interval decrease in left-sided pleural effusion which is now small. Lingular and retrocardiac opacity have also decreased. Moderate right-sided pleural effusion and basal opacity have slightly increased.	Interval decrease of left-sided pleural effusion. No pneumothorax.	18,478
The NG tube terminates in the distal esophagus and needs to be advanced significant background lung disease is identified including postoperative changes in the left apex. ET tube remains in unchanged position. The appearances in the right base suggests a sharp demarcation with the heart border and attention on followup to exclude a developing basilar pneumothorax suggested	NGT be knees. Advanced further.	6,684
Bilateral increased interstitial markings in the lower lungs are demonstrated but may reflect underlying emphysema. Retrocardiac opacity with silhouetting of the left hemidiaphragm border could reflect edema, atelectasis or consolidation/ pneumonia. A nodular opacity projecting over the left lung apex likely represents a chronic rib deformity. No large pleural effusion. No pneumothorax. Perihilar asymmetric opacities in the left lung could also represent foci of infection.	Retrocardiac opacity and asymmetric left perihilar opacities could reflect edema though pneumonia cannot be excluded in the appropriate clinical situation. Emphysema.	13,382
Assessment is limited by patient positioning and rotation. There are low lung volumes. Mild to moderate enlargement of the cardiac silhouette is grossly unchanged. The aorta appears diffusely calcified. The mediastinal and hilar contours are not substantially changed in the interval. Crowding of bronchovascular structures is noted and mild pulmonary vascular congestion is likely present. Streaky opacities in the lung bases may reflect areas of atelectasis. No large pleural effusion or pneumothorax is present.	Limited study due to low lung volumes and patient rotation. Patchy opacities in the lung bases may reflect atelectasis but infection is not excluded in the correct clinical setting.	3,818
Heart size is within normal limits. Hilar contours are unremarkable. No evidence of pulmonary edema. Reticular opacities are noted at bilateral lung bases and right apex. This may reflect an interstitial process. No large pleural effusion or pneumothorax is seen. Visualized osseous structures demonstrates no acute abnormality.	No acute intrathoracic abnormality. Endotracheal tube in appropriate position. Reticular opacities at the lung bases and right apex may reflect scarring.	5,193
The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fracture is identified.	No acute cardiopulmonary process. No acute displaced rib fracture identified.	4,004
The cardiac, mediastinal and hilar contours appear within normal limits. There is no pleural effusion. No pneumothorax is demonstrated. The lungs appear clear.	No evidence of acute cardiopulmonary disease.	11,096
Bilateral mild and diffuse pulmonary opacities is likely mild pulmonary edema. Increased retrocardiac density reflects left lower lung atelectasis. Aorta is mildly tortuous and moderately calcified. Heart size is top normal. Mediastinal and hilar contours are unremarkable. Small left pleural effusion is presumed.	Mild pulmonary edema and left lower lung atelectasis. Small left small pleural effusion is presumed.	6,970
The lung volumes are low. There are bibasilar subsegmental/linear atelectasis. Possible small left pleural effusion. There has been interval extubation and removal of the enteric tube. Right-sided central venous catheter tip terminates at the cavoatrial junction. Mild cardiomegaly and postsurgical changes project over the middle mediastinum. Visualized bones are unremarkable. EKG leads overlie the chest wall. Sternotomy sutures are unchanged.	Low lung volumes with bibasilar linear atelectasis and likely a small left pleural effusion. Interval extubation and removal of the enteric tube.	17,539
Left PICC line is unchanged, ending in mid SVC. Lung volume is normal with increased left base opacification suspicious for pneumonia likely due to with aspiration. Right lung is clear. There is no pneumothorax. Cardiomediastinal silhouette is normal. Reduced central vein engorgment.	Interval increase of left base opacification is compatible with aspiration pneumonia	11,729
The lung volumes are low. There is no pleural effusion, pneumothorax or focal airspace consolidation. The heart is mildly enlarged but unchanged. There is no pulmonary edema. The mediastinal and hilar contours are unremarkable.	Stable, mild cardiomegaly.	7,103
The course of an enteric tube is unchanged. A left subclavian venous catheter terminates in the mid superior vena cava. There are increasing basilar opacities, including in the right lower lung, probably in the right lower lobe, and also suspected layering pleural effusions, superimposed on a pre-existing retrocardiac opacity.	Increasing basilar opacities with suspected pleural effusions. Short-term follow-up radiographs are recommended.	9,683
An enteric tube is within the stomach. Heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. Patchy opacities are seen in the lung bases which may reflect areas of atelectasis in the setting of low lung volumes. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is demonstrated.	Standard positioning of the endotracheal and enteric tubes. Low lung volumes with patchy bibasilar airspace opacities, likely atelectasis.	16,987
Frontal portable radiographs of the chest demonstrate normal heart size. The right hilus is enlarged. The lungs are clear. No pleural effusion or pneumothorax.	Enlarged right hilus, recommend further evaluation with chest CT.	14,059
The lungs are clear. There is no pneumothorax. Moderate cardiomegaly has slightly increased. There is no pneumothorax.	Clear lungs. No pneumothorax.	16,782
Portable chest radiograph demonstrates a new enteric tube descending and uncomplicated course, its terminal end within the expected location of the stomach. The side port appears to be at the gastroesophageal junction. A right PICC is seen terminating at the mid SVC. The cardiomediastinal contour is stable. The lungs appear unchanged with no new focal consolidations. No pneumothorax.	New enteric tube, this terminal tip projecting over the expected location of the stomach.	11,616
Portable single frontal chest radiograph was obtained with the patient in semi-upright position. There has been interval increase in the opacity projecting over the left hemithorax. There is complete opacification of the left lung base with air bronchograms and obscuration of the left hemidiaphragm. There has also been interval increase in the right base opacity. There is no pneumothorax. The heart size is difficult to assess given parenchymal abnormalities.	Interval increase in opacity projecting over the left hemithorax, which may indicate worsening pneumonia, loculated effusion, or parenchymal or pleural hemorrhage. Interval worsening in the right lower lung opacification, which may reflect additional area of consolidation or atelectasis.	415
Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion.	No acute cardiopulmonary abnormality	7,971
A left central line terminates in the proximal right atrium. A right Port-A-Cath terminates in the low SVC. A feeding tube terminates in the stomach. There are low lung volumes. Alveolar opacities are seen diffusely through the bilateral lungs, along with cardiomegaly, consistent with moderate pulmonary edema. Bilateral pleural effusions likely present. No pneumothorax seen.	Moderate pulmonary edema with probable bilateral pleural effusions.	17,348
No pneumothorax is detected. Inspiratory volumes are now lower, with atelectasis or other patchy opacity in the right cardiophrenic region. The possibility of an early pneumonic infiltrate in this location cannot be excluded. There is probably also minimal atelectasis at the left lung base. No frank consolidation is identified. The mid and upper zones of both lungs are clear. No effusion.	Patchy opacity right cardiophrenic region with lower lung volumes - atelectasis versus early pneumonic infiltrate.	13,451
A portable semi-upright radiograph of the chest demonstrates interval increase in left-sided pleural effusion and adjacent atelectasis and new small right-sided pleural effusion with adjacent atelectasis. Stable appearing biapical scarring and multiple calcified granulomas in the left upper lung. Cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. No pneumomediastinum.	No free air.	18,368
There has been interval placement of a right pleural pigtail catheter. There is a persistent large right pneumothorax. Subcutaneous emphysema is also noted. The left lung is clear with suture material projecting over the apex. The cardiac silhouette is unchanged. No pleural effusion is identified.	Interval placement of a right pleural pigtail catheter with a persistent large right pneumothorax.	17,853
Dominant central cavitary lesions are similar in appearance. Widespread preibronchial abnormality is worsened concerning for worsening infection. No pneumothorax or pleural effusion seen. Heart is normal in size.	Stable cavitary lesions but worsening peribronchial opacities concerning for worsening airways-related infection.	14,130
No change in the cardiac or mediastinal silhouettes. NG tube is visualized in the appropriate area, however the tip is unable to be seen. Recommend repeat chest x-ray to include upper abdomen using abdominal technique. No other significant interval change is appreciated.	NG tube in place with nonvisualization of tip. Recommend repeat chest x-ray with abdominal technique, to include upper abdomen. Recommendation for repeat film was relayed at this time.	4,408
There has been interval progression of a moderate to large right-sided pleural effusion. Lung volumes remain low, with mild pulmonary vascular congestion. Cardiomegaly is unchanged. Incidental note of several metallic BBs in the left chest soft tissues.	Interval progression of the right-sided pleural effusion, now moderate to large in size.	9,816
There has been interval placement of a right-sided pacer with distal aspect coiling in the region of the right ventricle. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette moderate to markedly enlarged. There is prominence of the hila suggesting pulmonary vascular engorgement without overt pulmonary edema. No large pleural effusion is seen, although the right costophrenic angle is not fully included on the image. No new focal consolidation. No pneumothorax.	Interval placement of right-sided pacer coiling in the region of the right ventricle. Suggest repositioning.	9,004
The lung apices have been excluded from the field of view. A newly placed nasogastric tube terminates in the stomach. Faintly increased airspace opacification at the right base may be due to new aspiration. The heart and mediastinum are magnified by the projection. Limited view of the upper abdomen is unremarkable.	Newly placed NG tube terminates in the stomach. Faint airspace opacity at the right base may be due to new aspiration.	1,724
There is no pneumothorax or complications seen. The lungs are well expanded. Again seen is a large left perihilar mass, which is unchanged. There are no pleural effusions. There is significant scoliosis of the thoracolumbar spine.	ET tube in good position. Otherwise, unchanged chest radiograph.	5,474
Left PICC tip terminates in the low SVC. Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. A mortise calcification adjacent to the left humeral head suggests calcific tendinopathy.	Left PICC tip terminates in the low SVC.	11,932
The right PICC ends in the mid SVC. There is moderate cardiomegaly and pulmonary vascular congestion with likely mild interstitial pulmonary edema. There is bibasilar atelectasis. There is a small left pleural effusion. No pneumothorax.	Moderate cardiomegaly, and mild interstitial edema. Small left pleural effusion. Right PICC line is in appropriate position in the mid SVC.	14,170
The heart is mild to moderately enlarged. The mediastinal and hilar contours appear unchanged. The lungs appear clear aside from a calcified granuloma again projecting over the right upper lung. A trace pleural effusion is suspected on the right.	Trace right-sided pleural effusion, otherwise no significant change.	7,875
No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. Subtle rounded opacity projecting over the left lower hemi thorax may represent nipple shadow. This could be confirmed with repeat with nipple markers. Bilateral spinal rods are partially imaged and not optimally assessed on this study, however, no obvious spinal rod fracture is seen. No pulmonary edema.	No focal consolidation. Subtle rounded opacity projecting over the left lower hemi thorax over the left anterior fifth rib may represent nipple shadow. This can be confirmed with repeat with nipple markers.	11,385
A new central venous catheter terminates in the left brachiocephalic vein. There is no pneumothorax. Otherwise, there has been no significant short-term change.	Status post placement of new left internal jugular central venous catheter; no pneumothorax identified.	12,736
There has been interval placement of the right-sided chest tube with dramatic decrease in the right pleural effusion. There is still a right effusion layering posteriorly and volume loss in the right mid and upper lung. It is unclear how much of the right peritracheal and right hilar mass is due to volume loss in how much of it is due to tumor there is a small right apical pneumothorax. The left lung is relatively clear	Interval decrease in right effusion	13,095
Portable single frontal chest radiograph was obtained. An NG tube terminates in the fundus of the stomach with the side hole near the GE junction. Lung volumes are low. There is a small left pleural effusion with compressive atelectasis at the left base. The heart is mildly enlarged with pulmonary vascular congestion. There is no pneumothorax.	Small left pleural effusion with compressive atelectasis. Mild cardiomegaly with pulmonary vascular congestion.	10,173
A new right IJ line ends in the low right atrium. There is no pneumothorax. Mild cardiomegaly in addition to a large hiatus hernia are unchanged. The mediastinal contours are stable. Lung volumes are low. There is left basilar atelectasis. Otherwise, there is no focal consolidation. There is no large pleural effusion.	New right IJ line terminates in the right atrium. No pneumothorax. Stable mild cardiomegaly. Unchanged large hiatus hernia.	12,671
The cardiac and mediastinal contours are stable. Bibasilar opacities persist. There is mild pulmonary vascular congestion, relatively unchanged but no overt pulmonary edema. There is a possible left pleural effusion. No pneumothorax. Dextroscoliosis is noted.	Persistent bibasilar opacities remain concerning for aspiration or pneumonia in the correct clinical setting.	1,748
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.	Interval increase in extent of left lower lobe opacity. No other significant change.	15,802
The right IJ line tip is in the SVC. The remainder the appearance of the lungs are unchanged	IJ line in distal SVC	11,785
AP portable upright view of the chest. A right-sided thoracostomy tube is unchanged in position. There has been interval removal of Swan-Ganz catheter. A left subclavian central venous catheter terminates at the cavoatrial junction. There is no pleural effusion. The heart size remains normal. The hilar and mediastinal contours are within normal limits.	Interval enlargement of a small right pneumothorax. A right thoracostomy tube remains unchanged in position.	10,880
Exam is limited by patient positioning with the patient's chin obscuring a portion of the right apex. Low lung volumes are demonstrated. The heart size is difficult to assess, but is likely within normal limits. The aorta is tortuous. Opacification of the right lung base likely reflects a combination of consolidation with small right pleural effusion. There is mild pulmonary vascular congestion. No pneumothorax is demonstrated. There is gaseous distention of the stomach. Severe S-shaped scoliosis of the thoracolumbar spine is demonstrated with multilevel degenerative changes. Partially imaged are severe degenerative changes of the right glenohumeral joint. Remote left-sided rib fractures are again noted.	Limited exam. Right basilar opacity is concerning for pneumonia or aspiration with a small right pleural effusion. Mild pulmonary vascular engorgement. No pneumothorax is identified. Gaseous distention of the stomach incidentally noted.	14,521
No pneumothorax is evident on this examination. Heart size and mediastinal contours appear within normal limits. Diffuse opacity throughout the lungs is consistent with known nodular pulmonary disease. In addition, superimposed nodular densities correspond to macroscopic nodules seen previously at CT. There is no pleural effusion. Osseous structures appear unchanged.	No pneumothorax.	11,549
Enteric tube tip projected over mid stomach. Left subclavian central line tip in the low SVC. Stable bilateral perihilar opacities, and medial left lower lobe opacity. Stable elevation of the right hemidiaphragm. Postoperative changes in the abdomen. Prominent central pulmonary artery, suggests pulmonary artery hypertension. Stable appearance of the right AC joint.	Enteric tube tip projected over mid stomach.	17,685
Single portable view of the chest. Increased interstitial markings are seen throughout the lungs. There is also focal increased opacity at the right lung base overlying the hemidiaphragm and region of atelectasis seen on previous exam. No other focal consolidation identified. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.	Pulmonary vascular congestion and right basilar opacity, may be atelectasis, although infection is not entirely excluded.	18,769
The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. Note is made of mild pleural thickening adjacent to the lateral left 8th rib. There may also be a subtle non-displaced fracture of the left lateral 8th rib.	Possible subtle non-displaced fracture of the left lateral 8th rib, with adjacent mild pleural thickening. Please correlate clinically. No pneumothorax.	10,504
There is no pneumothorax. Right there is a possible tiny right pleural effusion. There is no focal infiltrate.	No pneumothorax.	17,008
Semi-upright portable AP view of the chest was provided. There are acute minimally displaced fractures involving the lateral arches of the right fifth and sixth ribs. No additional fractures are seen. The lungs are clear and well inflated. No pneumothorax or pleural effusion. Cardiomediastinal silhouette normal.	Acute mildly displaced fractures of the lateral arch of the right fifth and sixth ribs. Findings were posted to the ED dashboard at the time of initial review.	4,269
There is volume loss in both lower lungs and bilateral pleural effusions and underlying infectious infiltrate in the lower lobes can't be excluded. NG tube tip is in the stomach.	Improved location of ETT	3,396
There is pulmonary vascular congestion with mild pulmonary edema. Left retrocardiac opacity is consistent with atelectasis. No focal consolidation, pleural effusion or pneumothorax. Mediastinal and hilar contours are stable. Severe cardiomegaly is unchanged.	No evidence of pneumonia. Mild pulmonary edema. Stable substantial cardiomegaly. Left retrocardiac opacity is consistent with atelectasis.	1,063
Portable single frontal chest x-ray was obtained with the patient in upright position. A right PICC terminates in the lower SVC. There is no evidence of complications or pneumothorax. There is mild cardiomegaly with vascular congestion. No focal consolidation, pleural effusion, or pneumothorax is seen.	PICC terminating in lower SVC without evidence of complications.	12,906
An apical right chest tube is in unchanged position. No pneumothorax is identified. There is substantial volume loss in the right lung evidenced by shift of the mediastinum to the right and an additional new opacity in the right upper lobe may be the sequela of collapse. The left lung is essentially clear. Adjacent to to the mediastinum is noted as a lucent sliver consistent with air tracking along the right heart border.	Pneumomediastinum. Progressive collapse of the right upper lobe.	3,542
There low lung volumes with accentuation of the cardiomediastinal silhouette and pulmonary vasculature. No obvious rib fracture, pneumothorax, or pleural effusion.	No obvious cardiopulmonary process or traumatic injury.	3,472
Interval re-expansion of left lower lobe, with minimal residual atelectasis, and possible trace pleural effusion. Stable elevation left hemidiaphragm. Normal heart size, pulmonary vascularity. Right lung is clear. No pneumothorax.	Re-expansion of the left lower lobe.	13,117
Heart size upper limits are normal. Normal pulmonary vascularity. Lungs are clear. No pleural effusions. No pneumothorax.	No infiltrates.	9,861
AP portable upright view of the chest. Bibasilar atelectasis again noted. No convincing sign of free air. Cardiomediastinal silhouette appears grossly unchanged. No definite pneumothorax or effusion. Bony structures are intact. Gas-filled loops of bowel noted in the upper abdomen.	Bibasilar atelectasis. Gas-filled distended bowel loops in the upper abdomen, likely reflect known 's pseudo-obstruction though clinical correlation is advised.	13,613
Study is moderately limited by significant patient rotation. Increased airspace opacity over the right upper lung may be related to superimposition of structures related to rotation or early consolidation. Opacity of the left lung base may represent a small effusion with associated atelectasis. There is no pneumothorax or pulmonary edema. Thoracic compression fractures are incompletely assess, likely similar to prior studies. The cardiomediastinal silhouette is distorted due to patient rotation but likely unchanged.	Moderately limited study due to patient rotation. Possible airspace abnormality in the right upper lung may be artifactual or an early consolidation. Possible small left pleural effusion with associated atelectasis.	19,820
Endotracheal tube terminates at the level of clavicles. Enteric catheter courses below the left hemidiaphragm and outlet view. Cardiomediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax identified. No osseous abnormalities present.	medical support devices. No acute intrathoracic process.	16,677
An enteric tube courses into the stomach. The lungs are clear and lung volumes are normal. No pleural effusion, pneumothorax focal airspace consolidation. Heart is normal size. Mediastinal and hilar structures are unremarkable.	Well-positioned endotracheal tube.	4,022
There is prominence of the pulmonary vasculature, consistent with pulmonary congestion. Bibasilar opacities most likely represent atelectasis. There may be small pleural effusions. There is no pneumothorax. The cardiomediastinal silhouette is normal. The bones are intact.	Pulmonary vascular congestion with possible small bilateral pleural effusions. Bibasilar opacities, likely atelectasis.	8,540
The cardiac, mediastinal and hilar contours appear unchanged. The heart is normal in size. There is no pleural effusion or pneumothorax. The lungs appear clear.	No evidence of acute disease.	5,308
Moderate cardiomegaly, mild pulmonary edema, and small, left greater than right pleural effusions are unchanged. No new focal opacities. No pneumothorax. A right-sided IJ Swan-Ganz catheter terminates in the mid descending right pulmonary artery, beyond optimal placement. Median sternotomy wires are intact and unchanged in alignment.	Moderate cardiomegaly, mild pulmonary edema, and small, left greater than right pleural effusions are unchanged. A right-sided IJ Swan-Ganz catheter terminates beyond optimal positioning.	3,873
The lungs are clear, without consolidation or were pulmonary edema. The cardiac silhouette remains enlarged, secondary to pericardial effusion as seen on CT of the chest from . Left basilar consolidation is more prominent, likely atelectasis. The mediastinal and hilar contours are unremarkable. Mild left pleural effusion is similar. Trace right pleural effusions. There is no pneumothorax. There are degenerative changes of the left glenohumeral joint and bilateral acromioclavicular joints.	No pneumothorax.	1,973
The lungs are hyperexpanded. A right PICC ends in the mid SVC. There has been interval removal of an enteric tube. There is no pneumothorax. Small bilateral pleural effusions. Patchy opacities at the right lung base is new. Osseous structures are grossly unremarkable.	Patchy opacities at the right lung base may be consistent with aspiration or pneumonia. No pneumothorax.	387
Single portable view of the chest. Enteric tube passes below the diaphragm with tip in the gastric fundus. Low lung volumes are seen with secondary crowding of the bronchovascular markings. No confluent consolidation identified. Cardiomediastinal silhouette is within normal limits.	Endotracheal tube in appropriate position.	4,767
Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. The cardiomediastinal and hilar contours are improving, and are similar to the patient's baseline. There is no pneumothorax, pleural effusion or consolidation. The right-sided internal jugular central venous line ends in the cavoatrial junction.	No pneumothorax. Right-sided internal jugular central venous line ends in the cavoatrial junction.	3,210
Lungs are expanded and clear. No pleural abnormality. Heart size is top-normal. Cardiomediastinal hilar silhouettes are unremarkable. A Dobhoff tube terminates in the gastric fundus.	No evidence of acute cardiopulmonary abnormality.	12,282
An enteric tube extends below the diaphragm with the tip out of view of this film. The heart size is normal. The hilar and mediastinal contours are normal. Evaluation of the left lung is limited due to technique, however the right lung is unremarkable. The visualized subdiaphragmatic bowel appears to be distended, consistent with patient's known small bowel obstruction.	NG tube extends below the diaphragm, with the tip out of view of this film.	17,547
Mild pulmonary edema is present. Left lower lung opacity is likely a combination of small atelectasis and probably a small effusion. Right small pleural effusion is presumed. Heart size is mildly enlarged, and the pulmonary vasculature is minimally congested. A right central line tip ends at lower SVC.	Mild pulmonary edema. Left lower lung opacity is likely a combination of atelectasis and effusion and right lung base atelectasis is minimal. There is no evidence of pneumothorax.	17,182
Frontal view of the chest was obtained. Leads of a left-sided pacer terminate in the right atrium and ventricle. Moderate cardiomegaly with calcification of the aortic knob are stable. Hyperinflated lungs are consistent with chronic obstructive pulmonary disease. Interstitial lung markings are increased, consistent with mild pulmonary edema. Retrocardiac and right lung base opacities may represent a combination of atelectasis and effusion.	Mild pulmonary edema with bibasilar atelectasis. Stable moderate cardiomegaly.	16,947
There are diffuse airspace opacities spanning nearly the totality of both lungs, with some sparing of an ill-defined region in the right upper lung. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.	Bilateral opacities occupying nearly the totality of the lungs consistent with acute pulmonary edema. Diffuse reactive inflammatory process such as pneumonitis or infection cannot be excluded.	18,457
There has been interval removal of the malpositioned Dobbhoff tube. There is no evidence of pneumothorax. Small bilateral pleural effusions are likely. The cardiomediastinal and hilar contours are normal. Lung volumes are low, but there is no focal consolidation concerning for pneumonia. Right PICC line is again noted, tip terminating in the mid SVC. The upper abdomen is unremarkable in appearance.	Interval removal of the malpositioned Dobbhoff tube with no evidence of pneumothorax or other complication.	19,194
AP portable upright view of the chest provided. No free air below the right hemidiaphragm. Lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact.	No evidence of free air below the right hemidiaphragm.	3,294
Other support and monitoring devices remain stable. The right pleural effusion and pulmonary edema are improved, specifically the right middle lobe opacity which may have been due to asymmetric edema or aspiration has improved. There remains pneumoperitoneum which may be increasing. Additionally, there is new left soft tissue emphysema.	Stable to increasing pneumoperitoneum with new left-sided subcutaneous emphysema. These findings raise concern about appropriate functionality of the gastrostomy tube. telephone on . Improved pulmonary edema.	15,287
The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. . No pneumonia, no pulmonary edema. No pleural effusions.	Normal chest radiograph without pneumonia.	19,004
Lung volumes are low, resulting in bronchovascular crowding, but the appearance of the lungs is otherwise unremarkable for supine positioning. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation.	No acute cardiopulmonary process. Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted, the location of any referrable focal findings should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning.	9,446
Again is seen a left-sided double-lumen central venous catheter with tip at the lower SVC. The cardiomediastinal and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax. An IVC filter is in place.	No acute cardiopulmonary process.	2,300
The patient is mildly rotated. Right PICC tip terminates in the upper SVC. The cardiac, mediastinal and hilar contours are unchanged, and the heart size is normal. Lungs are clear. No pleural effusion, focal consolidation or pneumothorax is identified. No acute osseous abnormality seen.	No acute cardiopulmonary abnormality.	10,608
Increased left lower lobe opacification is suggestive of infectious focus. The left heart border is not well-visualized. No pleural effusions. Right Port-A-Cath terminates in the right atrium. No pneumothorax.	Left lower lobe and lingular pneumonia. A. by , M. D.	12,824
Lung volumes are low with vascular crowding but there is no definite new consolidation to suggest pneumonia. Cardiomediastinal silhouette remains stable. Support devices are unchanged.	No acute pneumonia.	5,781
Portable semi-upright radiograph of the chest demonstrates low lung volumes. The cardiac silhouette is stable. No focal consolidation is identified. There are possible small pleural effusions. A right-sided venous catheter terminates in the mid SVC.	No CHF or pneumonia. Possible small pleural effusions.	15,995
The cardiac silhouette remains enlarged. The aorta calcified and tortuous. No pleural effusion or pneumothorax is seen. No overt pulmonary edema is. Patchy right base opacity most likely represents overlap of vascular structures although early pneumonia is not excluded in the appropriate clinical setting.	Patchy right base opacity most likely represents overlap of vascular structures although early pneumonia is not excluded in the appropriate clinical setting.	1,892
The lungs are well expanded and clear. There is stable cardiomegaly. There is no pneumothorax or pleural effusion. There is DJD at both shoulders.	No acute cardiopulmonary process.	18,481
Endotracheal tube tip is just above carina, should be pulled back. Endotracheal tube tip is well below diaphragm. Shallow inspiration. There are left basilar nodular opacities, consider pneumonitis, possibly aspiration, or atelectasis. Right lung is clear. .	Endotracheal tube tip just above carina, should be pulled back. Left basilar opacities, consider pneumonitis, aspiration, or atelectasis.	1,695
Since , moderate to severe pulmonary edema has worsened and severe cardiomegaly is unchanged. No pneumothorax. Small pleural effusions are presumed but unchanged. Median sternotomy wires are intact and aligned.	Worsening moderate to severe pulmonary edema with unchanged severe cardiomegaly.	19,944
Single portable chest radiograph was provided. Lung volumes are low. Streaky retrocardiac and right lower lobe opacities are likely atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is unchanged. Clips and spinal hardware are incompletely visualized in the lumbar spine.	Low lung volumes and atelectasis, otherwise no acute process.	11,358
Single frontal view of the chest demonstrates a prominent cardiac silhouette, likely accentuated by AP technique. The mediastinal and hilar contours are within normal limits. There is new increased left greater than right bibasilar opacities, which could reflect developing pneumonia in the appropriate clinical setting, alternatively aspiration could have a similar appearance. There may be trace left effusion. There is no pneumothorax. Pulmonary vascular congestion is mild.	New left greater than right bibasilar opacities could reflect infection versus aspiration.	19,050
Increased bilateral symmetric central pulmonary opacities seen. Name compatible with increased pulmonary edema.	Increased pulmonary edema	18,656
Single frontal view of the chest was obtained. Tracheostomy tube is in similar position to prior. Moderate cardiomegaly and cardiomediastinal contours are stable. Increased right base consolidative opacity is compatible with pneumonia or aspiration. Left base opacity could represent atelectasis or consolidation. No substantial pleural effusion or pneumothorax.	Right base consolidative opacity and patchy left base opacity are compatible with pneumonia or aspiration. Moderate cardiomegaly.	19,956

There has been interval removal of a left-sided PICC. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. A battery pack is seen overlying the medial left hemithorax. Cardiac and mediastinal silhouettes are stable. Surgical clips are seen in the upper abdomen.

No acute cardiopulmonary process.

6,913

Lung volumes are relatively low with left greater than right bibasilar opacities which are likely secondary to atelectasis. Superiorly, the lungs are clear. The cardiomediastinal silhouette is within normal limits. There is a comminuted proximal left humerus fracture with suggestion of callus formation.

Bibasilar opacities which are likely atelectasis. Comminuted proximal left humerus fracture, with suggestion of callus formation suggesting this is not acute but clinical correlation is suggested.

11,229

Right internal jugular central venous line terminates in the superior aspect of the right atrium. No evidence of pneumothorax. Significant bibasilar atelectasis is noted. Small bilateral pleural effusions are noted.

Right internal jugular central venous line terminates in the superior aspect of the right atrium. Significant bibasilar atelectasis.

11,236

Nasogastric tube projects over the esophagus and courses out of sight inferiorly. Right-sided IJV catheter in situ with the tip in the proximal SVC. The left upper lobe mass is again identified with mediastinal shift to the right. There has been new development of opacification of the left lower lobe with minimal residual aeration in the inferior aspect of the left lower lobe. The right lung is clear.

There is a new opacification of the left lower lobe, and I get the impression of volume gain suggesting airspace consolidation rather than atelectasis.

17,028

The left PICC line is malpositioned, terminating within the right brachiocephalic vein. The linear opacities within the left midlung likely represent atelectasis, although the previously visualized bibasilar atelectasis has significantly improved. There is mild vascular congestion, but no frank pulmonary edema. The cardiac silhouette is enlarged but stable. There are no large pleural effusions. There is no pneumothorax.

Malpositioned left PICC line within the right brachiocephalic vein. Mild vascular congestion. Improved bibasilar atelectasis.

13,837

The moderate left effusion appears unchanged. There is likely a new small right pleural effusion. The enteric tube passes below the diaphragm and outside of the field of view within a decompressed stomach. The left-sided PICC line ends in the high SVC. There is mild pulmonary vascular congestion without frank pulmonary edema. There is no focal consolidation or pneumothorax. The cardiomediastinal silhouette is within normal limits.

New small right pleural effusion. Mild volume overload.

3,906

The heart size is normal. The hilar and mediastinal contours are normal. A tracheostomy tube is seen in place. There is a well-circumscribed rounded opacity along the medial left lung base which appears more prominent, compared to the prior exam. There is no evidence of a pneumothorax. The bones are diffusely osteopenic, which are otherwise unremarkable.

Rounded opacity at the left lung base appears more prominent compared to the prior exam. This raises concern for diaphragmatic herniation or possibly rupture. Further imaging evaluation with CT may be helpful. No evidence of pneumonia.

19,838

Portable semi-upright radiograph of the chest demonstrates well expanded lungs. There is bibasilar atelectasis without definite consolidation. Minimal left pleural effusion. Mediastinal and hilar contours are unremarkable. There is no pneumothorax.

Bibasilar atelectasis without definite consolidation.

10,884

AP portable supine view of the chest. Dual lead pacer is noted with pacer pack projecting over the left chest wall and leads extending to the region of the right atrium and right ventricle. Predominately left-sided calcified pleural plaque is noted likely accounting for the opacity projecting over the lateral aspect of the left lower lung. Evaluation for a subtle pneumonia in this area is therefore limited. Otherwise, no signs of pneumonia. No supine evidence for effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Chronic right rib deformities are noted involving the fourth, fifth, sixth, seventh, eighth, and ninth ribs.

Chronic right rib cage deformities. Calcified pleural plaque. Pacemaker in appropriate position. If there is strong clinical concern for an acute fracture, recommend dedicated rib series with a BB marking the site of maximal pain.

4,985

Right-sided Port-A-Cath tip terminates in the SVC. The heart size is normal. Mediastinal and hilar contours are unchanged. There has been interval improvement in aeration of the left lung base. A small left pleural effusion is likely present. Persistent partially loculated small to moderate right pleural effusion is unchanged with adjacent right basilar opacity likely reflecting compressive atelectasis. No pulmonary edema or pneumothorax is identified.

Interval improvement in aeration of the left lung base. Bilateral pleural effusions, right greater than left, relatively unchanged. Right basilar opacity likely reflects compressive atelectasis though infection cannot be completely excluded.

403

Heart size is normal. The aorta is slightly unfolded. The pulmonary vasculature is normal. Hilar contours are normal. Subsegmental atelectasis is noted in the right lung base. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities detected.

Subsegmental right basilar atelectasis.

8,130

There is a right central venous line that ends at the cavoatrial junction. The heart size is normal, and the patient is status post median sternotomy. There is bibasilar opacities reflecting fibrosis as noted on the dedicated chest CT. There is no pleural effusion or pulmonary edema.

Pulmonary fibrosis including in the right upper lobe is better assessed on the dedicated chest CT.

16,727

Stable right-sided Port-A-Cath in the mid SVC. Left PleurX catheter also in similar configuration. Interval decrease in left-sided pleural effusion which is now small. Lingular and retrocardiac opacity have also decreased. Moderate right-sided pleural effusion and basal opacity have slightly increased.

Interval decrease of left-sided pleural effusion. No pneumothorax.

18,478

The NG tube terminates in the distal esophagus and needs to be advanced significant background lung disease is identified including postoperative changes in the left apex. ET tube remains in unchanged position. The appearances in the right base suggests a sharp demarcation with the heart border and attention on followup to exclude a developing basilar pneumothorax suggested

NGT be knees. Advanced further.

6,684

Bilateral increased interstitial markings in the lower lungs are demonstrated but may reflect underlying emphysema. Retrocardiac opacity with silhouetting of the left hemidiaphragm border could reflect edema, atelectasis or consolidation/ pneumonia. A nodular opacity projecting over the left lung apex likely represents a chronic rib deformity. No large pleural effusion. No pneumothorax. Perihilar asymmetric opacities in the left lung could also represent foci of infection.

Retrocardiac opacity and asymmetric left perihilar opacities could reflect edema though pneumonia cannot be excluded in the appropriate clinical situation. Emphysema.

13,382

Assessment is limited by patient positioning and rotation. There are low lung volumes. Mild to moderate enlargement of the cardiac silhouette is grossly unchanged. The aorta appears diffusely calcified. The mediastinal and hilar contours are not substantially changed in the interval. Crowding of bronchovascular structures is noted and mild pulmonary vascular congestion is likely present. Streaky opacities in the lung bases may reflect areas of atelectasis. No large pleural effusion or pneumothorax is present.

Limited study due to low lung volumes and patient rotation. Patchy opacities in the lung bases may reflect atelectasis but infection is not excluded in the correct clinical setting.

3,818

Heart size is within normal limits. Hilar contours are unremarkable. No evidence of pulmonary edema. Reticular opacities are noted at bilateral lung bases and right apex. This may reflect an interstitial process. No large pleural effusion or pneumothorax is seen. Visualized osseous structures demonstrates no acute abnormality.

No acute intrathoracic abnormality. Endotracheal tube in appropriate position. Reticular opacities at the lung bases and right apex may reflect scarring.

5,193

The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fracture is identified.

No acute cardiopulmonary process. No acute displaced rib fracture identified.

4,004

The cardiac, mediastinal and hilar contours appear within normal limits. There is no pleural effusion. No pneumothorax is demonstrated. The lungs appear clear.

No evidence of acute cardiopulmonary disease.

11,096

Bilateral mild and diffuse pulmonary opacities is likely mild pulmonary edema. Increased retrocardiac density reflects left lower lung atelectasis. Aorta is mildly tortuous and moderately calcified. Heart size is top normal. Mediastinal and hilar contours are unremarkable. Small left pleural effusion is presumed.

Mild pulmonary edema and left lower lung atelectasis. Small left small pleural effusion is presumed.

6,970

The lung volumes are low. There are bibasilar subsegmental/linear atelectasis. Possible small left pleural effusion. There has been interval extubation and removal of the enteric tube. Right-sided central venous catheter tip terminates at the cavoatrial junction. Mild cardiomegaly and postsurgical changes project over the middle mediastinum. Visualized bones are unremarkable. EKG leads overlie the chest wall. Sternotomy sutures are unchanged.

Low lung volumes with bibasilar linear atelectasis and likely a small left pleural effusion. Interval extubation and removal of the enteric tube.

17,539

Left PICC line is unchanged, ending in mid SVC. Lung volume is normal with increased left base opacification suspicious for pneumonia likely due to with aspiration. Right lung is clear. There is no pneumothorax. Cardiomediastinal silhouette is normal. Reduced central vein engorgment.

Interval increase of left base opacification is compatible with aspiration pneumonia

11,729

The lung volumes are low. There is no pleural effusion, pneumothorax or focal airspace consolidation. The heart is mildly enlarged but unchanged. There is no pulmonary edema. The mediastinal and hilar contours are unremarkable.

Stable, mild cardiomegaly.

7,103

The course of an enteric tube is unchanged. A left subclavian venous catheter terminates in the mid superior vena cava. There are increasing basilar opacities, including in the right lower lung, probably in the right lower lobe, and also suspected layering pleural effusions, superimposed on a pre-existing retrocardiac opacity.

Increasing basilar opacities with suspected pleural effusions. Short-term follow-up radiographs are recommended.

9,683

An enteric tube is within the stomach. Heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. Patchy opacities are seen in the lung bases which may reflect areas of atelectasis in the setting of low lung volumes. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is demonstrated.

Standard positioning of the endotracheal and enteric tubes. Low lung volumes with patchy bibasilar airspace opacities, likely atelectasis.

16,987

Frontal portable radiographs of the chest demonstrate normal heart size. The right hilus is enlarged. The lungs are clear. No pleural effusion or pneumothorax.

Enlarged right hilus, recommend further evaluation with chest CT.

14,059

The lungs are clear. There is no pneumothorax. Moderate cardiomegaly has slightly increased. There is no pneumothorax.

Clear lungs. No pneumothorax.

16,782

Portable chest radiograph demonstrates a new enteric tube descending and uncomplicated course, its terminal end within the expected location of the stomach. The side port appears to be at the gastroesophageal junction. A right PICC is seen terminating at the mid SVC. The cardiomediastinal contour is stable. The lungs appear unchanged with no new focal consolidations. No pneumothorax.

New enteric tube, this terminal tip projecting over the expected location of the stomach.

11,616

Portable single frontal chest radiograph was obtained with the patient in semi-upright position. There has been interval increase in the opacity projecting over the left hemithorax. There is complete opacification of the left lung base with air bronchograms and obscuration of the left hemidiaphragm. There has also been interval increase in the right base opacity. There is no pneumothorax. The heart size is difficult to assess given parenchymal abnormalities.

Interval increase in opacity projecting over the left hemithorax, which may indicate worsening pneumonia, loculated effusion, or parenchymal or pleural hemorrhage. Interval worsening in the right lower lung opacification, which may reflect additional area of consolidation or atelectasis.

415

Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion.

No acute cardiopulmonary abnormality

7,971

A left central line terminates in the proximal right atrium. A right Port-A-Cath terminates in the low SVC. A feeding tube terminates in the stomach. There are low lung volumes. Alveolar opacities are seen diffusely through the bilateral lungs, along with cardiomegaly, consistent with moderate pulmonary edema. Bilateral pleural effusions likely present. No pneumothorax seen.

Moderate pulmonary edema with probable bilateral pleural effusions.

17,348

No pneumothorax is detected. Inspiratory volumes are now lower, with atelectasis or other patchy opacity in the right cardiophrenic region. The possibility of an early pneumonic infiltrate in this location cannot be excluded. There is probably also minimal atelectasis at the left lung base. No frank consolidation is identified. The mid and upper zones of both lungs are clear. No effusion.

Patchy opacity right cardiophrenic region with lower lung volumes - atelectasis versus early pneumonic infiltrate.

13,451

A portable semi-upright radiograph of the chest demonstrates interval increase in left-sided pleural effusion and adjacent atelectasis and new small right-sided pleural effusion with adjacent atelectasis. Stable appearing biapical scarring and multiple calcified granulomas in the left upper lung. Cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. No pneumomediastinum.

No free air.

18,368

There has been interval placement of a right pleural pigtail catheter. There is a persistent large right pneumothorax. Subcutaneous emphysema is also noted. The left lung is clear with suture material projecting over the apex. The cardiac silhouette is unchanged. No pleural effusion is identified.

Interval placement of a right pleural pigtail catheter with a persistent large right pneumothorax.

17,853

Dominant central cavitary lesions are similar in appearance. Widespread preibronchial abnormality is worsened concerning for worsening infection. No pneumothorax or pleural effusion seen. Heart is normal in size.

Stable cavitary lesions but worsening peribronchial opacities concerning for worsening airways-related infection.

14,130

No change in the cardiac or mediastinal silhouettes. NG tube is visualized in the appropriate area, however the tip is unable to be seen. Recommend repeat chest x-ray to include upper abdomen using abdominal technique. No other significant interval change is appreciated.

NG tube in place with nonvisualization of tip. Recommend repeat chest x-ray with abdominal technique, to include upper abdomen. Recommendation for repeat film was relayed at this time.

4,408

There has been interval progression of a moderate to large right-sided pleural effusion. Lung volumes remain low, with mild pulmonary vascular congestion. Cardiomegaly is unchanged. Incidental note of several metallic BBs in the left chest soft tissues.

Interval progression of the right-sided pleural effusion, now moderate to large in size.

9,816

There has been interval placement of a right-sided pacer with distal aspect coiling in the region of the right ventricle. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette moderate to markedly enlarged. There is prominence of the hila suggesting pulmonary vascular engorgement without overt pulmonary edema. No large pleural effusion is seen, although the right costophrenic angle is not fully included on the image. No new focal consolidation. No pneumothorax.

Interval placement of right-sided pacer coiling in the region of the right ventricle. Suggest repositioning.

9,004

The lung apices have been excluded from the field of view. A newly placed nasogastric tube terminates in the stomach. Faintly increased airspace opacification at the right base may be due to new aspiration. The heart and mediastinum are magnified by the projection. Limited view of the upper abdomen is unremarkable.

Newly placed NG tube terminates in the stomach. Faint airspace opacity at the right base may be due to new aspiration.

1,724

There is no pneumothorax or complications seen. The lungs are well expanded. Again seen is a large left perihilar mass, which is unchanged. There are no pleural effusions. There is significant scoliosis of the thoracolumbar spine.

ET tube in good position. Otherwise, unchanged chest radiograph.

5,474

Left PICC tip terminates in the low SVC. Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. A mortise calcification adjacent to the left humeral head suggests calcific tendinopathy.

Left PICC tip terminates in the low SVC.

11,932

The right PICC ends in the mid SVC. There is moderate cardiomegaly and pulmonary vascular congestion with likely mild interstitial pulmonary edema. There is bibasilar atelectasis. There is a small left pleural effusion. No pneumothorax.

Moderate cardiomegaly, and mild interstitial edema. Small left pleural effusion. Right PICC line is in appropriate position in the mid SVC.

14,170

The heart is mild to moderately enlarged. The mediastinal and hilar contours appear unchanged. The lungs appear clear aside from a calcified granuloma again projecting over the right upper lung. A trace pleural effusion is suspected on the right.

Trace right-sided pleural effusion, otherwise no significant change.

7,875

No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. Subtle rounded opacity projecting over the left lower hemi thorax may represent nipple shadow. This could be confirmed with repeat with nipple markers. Bilateral spinal rods are partially imaged and not optimally assessed on this study, however, no obvious spinal rod fracture is seen. No pulmonary edema.

No focal consolidation. Subtle rounded opacity projecting over the left lower hemi thorax over the left anterior fifth rib may represent nipple shadow. This can be confirmed with repeat with nipple markers.

11,385

A new central venous catheter terminates in the left brachiocephalic vein. There is no pneumothorax. Otherwise, there has been no significant short-term change.

Status post placement of new left internal jugular central venous catheter; no pneumothorax identified.

12,736

There has been interval placement of the right-sided chest tube with dramatic decrease in the right pleural effusion. There is still a right effusion layering posteriorly and volume loss in the right mid and upper lung. It is unclear how much of the right peritracheal and right hilar mass is due to volume loss in how much of it is due to tumor there is a small right apical pneumothorax. The left lung is relatively clear

Interval decrease in right effusion

13,095

Portable single frontal chest radiograph was obtained. An NG tube terminates in the fundus of the stomach with the side hole near the GE junction. Lung volumes are low. There is a small left pleural effusion with compressive atelectasis at the left base. The heart is mildly enlarged with pulmonary vascular congestion. There is no pneumothorax.

Small left pleural effusion with compressive atelectasis. Mild cardiomegaly with pulmonary vascular congestion.

10,173

A new right IJ line ends in the low right atrium. There is no pneumothorax. Mild cardiomegaly in addition to a large hiatus hernia are unchanged. The mediastinal contours are stable. Lung volumes are low. There is left basilar atelectasis. Otherwise, there is no focal consolidation. There is no large pleural effusion.

New right IJ line terminates in the right atrium. No pneumothorax. Stable mild cardiomegaly. Unchanged large hiatus hernia.

12,671

The cardiac and mediastinal contours are stable. Bibasilar opacities persist. There is mild pulmonary vascular congestion, relatively unchanged but no overt pulmonary edema. There is a possible left pleural effusion. No pneumothorax. Dextroscoliosis is noted.

Persistent bibasilar opacities remain concerning for aspiration or pneumonia in the correct clinical setting.

1,748

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.

Interval increase in extent of left lower lobe opacity. No other significant change.

15,802

The right IJ line tip is in the SVC. The remainder the appearance of the lungs are unchanged

IJ line in distal SVC

11,785

AP portable upright view of the chest. A right-sided thoracostomy tube is unchanged in position. There has been interval removal of Swan-Ganz catheter. A left subclavian central venous catheter terminates at the cavoatrial junction. There is no pleural effusion. The heart size remains normal. The hilar and mediastinal contours are within normal limits.

Interval enlargement of a small right pneumothorax. A right thoracostomy tube remains unchanged in position.

10,880

Exam is limited by patient positioning with the patient's chin obscuring a portion of the right apex. Low lung volumes are demonstrated. The heart size is difficult to assess, but is likely within normal limits. The aorta is tortuous. Opacification of the right lung base likely reflects a combination of consolidation with small right pleural effusion. There is mild pulmonary vascular congestion. No pneumothorax is demonstrated. There is gaseous distention of the stomach. Severe S-shaped scoliosis of the thoracolumbar spine is demonstrated with multilevel degenerative changes. Partially imaged are severe degenerative changes of the right glenohumeral joint. Remote left-sided rib fractures are again noted.

Limited exam. Right basilar opacity is concerning for pneumonia or aspiration with a small right pleural effusion. Mild pulmonary vascular engorgement. No pneumothorax is identified. Gaseous distention of the stomach incidentally noted.

14,521

No pneumothorax is evident on this examination. Heart size and mediastinal contours appear within normal limits. Diffuse opacity throughout the lungs is consistent with known nodular pulmonary disease. In addition, superimposed nodular densities correspond to macroscopic nodules seen previously at CT. There is no pleural effusion. Osseous structures appear unchanged.

No pneumothorax.

11,549

Enteric tube tip projected over mid stomach. Left subclavian central line tip in the low SVC. Stable bilateral perihilar opacities, and medial left lower lobe opacity. Stable elevation of the right hemidiaphragm. Postoperative changes in the abdomen. Prominent central pulmonary artery, suggests pulmonary artery hypertension. Stable appearance of the right AC joint.

Enteric tube tip projected over mid stomach.

17,685

Single portable view of the chest. Increased interstitial markings are seen throughout the lungs. There is also focal increased opacity at the right lung base overlying the hemidiaphragm and region of atelectasis seen on previous exam. No other focal consolidation identified. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.

Pulmonary vascular congestion and right basilar opacity, may be atelectasis, although infection is not entirely excluded.

18,769

The heart size is normal. The hilar and mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. Note is made of mild pleural thickening adjacent to the lateral left 8th rib. There may also be a subtle non-displaced fracture of the left lateral 8th rib.

Possible subtle non-displaced fracture of the left lateral 8th rib, with adjacent mild pleural thickening. Please correlate clinically. No pneumothorax.

10,504

There is no pneumothorax. Right there is a possible tiny right pleural effusion. There is no focal infiltrate.

No pneumothorax.

17,008

Semi-upright portable AP view of the chest was provided. There are acute minimally displaced fractures involving the lateral arches of the right fifth and sixth ribs. No additional fractures are seen. The lungs are clear and well inflated. No pneumothorax or pleural effusion. Cardiomediastinal silhouette normal.

Acute mildly displaced fractures of the lateral arch of the right fifth and sixth ribs. Findings were posted to the ED dashboard at the time of initial review.

4,269

There is volume loss in both lower lungs and bilateral pleural effusions and underlying infectious infiltrate in the lower lobes can't be excluded. NG tube tip is in the stomach.

Improved location of ETT

3,396

There is pulmonary vascular congestion with mild pulmonary edema. Left retrocardiac opacity is consistent with atelectasis. No focal consolidation, pleural effusion or pneumothorax. Mediastinal and hilar contours are stable. Severe cardiomegaly is unchanged.

No evidence of pneumonia. Mild pulmonary edema. Stable substantial cardiomegaly. Left retrocardiac opacity is consistent with atelectasis.

1,063

Portable single frontal chest x-ray was obtained with the patient in upright position. A right PICC terminates in the lower SVC. There is no evidence of complications or pneumothorax. There is mild cardiomegaly with vascular congestion. No focal consolidation, pleural effusion, or pneumothorax is seen.

PICC terminating in lower SVC without evidence of complications.

12,906

An apical right chest tube is in unchanged position. No pneumothorax is identified. There is substantial volume loss in the right lung evidenced by shift of the mediastinum to the right and an additional new opacity in the right upper lobe may be the sequela of collapse. The left lung is essentially clear. Adjacent to to the mediastinum is noted as a lucent sliver consistent with air tracking along the right heart border.

Pneumomediastinum. Progressive collapse of the right upper lobe.

3,542

There low lung volumes with accentuation of the cardiomediastinal silhouette and pulmonary vasculature. No obvious rib fracture, pneumothorax, or pleural effusion.

No obvious cardiopulmonary process or traumatic injury.

3,472

Interval re-expansion of left lower lobe, with minimal residual atelectasis, and possible trace pleural effusion. Stable elevation left hemidiaphragm. Normal heart size, pulmonary vascularity. Right lung is clear. No pneumothorax.

Re-expansion of the left lower lobe.

13,117

Heart size upper limits are normal. Normal pulmonary vascularity. Lungs are clear. No pleural effusions. No pneumothorax.

No infiltrates.

9,861

AP portable upright view of the chest. Bibasilar atelectasis again noted. No convincing sign of free air. Cardiomediastinal silhouette appears grossly unchanged. No definite pneumothorax or effusion. Bony structures are intact. Gas-filled loops of bowel noted in the upper abdomen.

Bibasilar atelectasis. Gas-filled distended bowel loops in the upper abdomen, likely reflect known 's pseudo-obstruction though clinical correlation is advised.

13,613

Study is moderately limited by significant patient rotation. Increased airspace opacity over the right upper lung may be related to superimposition of structures related to rotation or early consolidation. Opacity of the left lung base may represent a small effusion with associated atelectasis. There is no pneumothorax or pulmonary edema. Thoracic compression fractures are incompletely assess, likely similar to prior studies. The cardiomediastinal silhouette is distorted due to patient rotation but likely unchanged.

Moderately limited study due to patient rotation. Possible airspace abnormality in the right upper lung may be artifactual or an early consolidation. Possible small left pleural effusion with associated atelectasis.

19,820

Endotracheal tube terminates at the level of clavicles. Enteric catheter courses below the left hemidiaphragm and outlet view. Cardiomediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax identified. No osseous abnormalities present.

medical support devices. No acute intrathoracic process.

16,677

An enteric tube courses into the stomach. The lungs are clear and lung volumes are normal. No pleural effusion, pneumothorax focal airspace consolidation. Heart is normal size. Mediastinal and hilar structures are unremarkable.

Well-positioned endotracheal tube.

4,022

There is prominence of the pulmonary vasculature, consistent with pulmonary congestion. Bibasilar opacities most likely represent atelectasis. There may be small pleural effusions. There is no pneumothorax. The cardiomediastinal silhouette is normal. The bones are intact.

Pulmonary vascular congestion with possible small bilateral pleural effusions. Bibasilar opacities, likely atelectasis.

8,540

The cardiac, mediastinal and hilar contours appear unchanged. The heart is normal in size. There is no pleural effusion or pneumothorax. The lungs appear clear.

No evidence of acute disease.

5,308

Moderate cardiomegaly, mild pulmonary edema, and small, left greater than right pleural effusions are unchanged. No new focal opacities. No pneumothorax. A right-sided IJ Swan-Ganz catheter terminates in the mid descending right pulmonary artery, beyond optimal placement. Median sternotomy wires are intact and unchanged in alignment.

Moderate cardiomegaly, mild pulmonary edema, and small, left greater than right pleural effusions are unchanged. A right-sided IJ Swan-Ganz catheter terminates beyond optimal positioning.

3,873

The lungs are clear, without consolidation or were pulmonary edema. The cardiac silhouette remains enlarged, secondary to pericardial effusion as seen on CT of the chest from . Left basilar consolidation is more prominent, likely atelectasis. The mediastinal and hilar contours are unremarkable. Mild left pleural effusion is similar. Trace right pleural effusions. There is no pneumothorax. There are degenerative changes of the left glenohumeral joint and bilateral acromioclavicular joints.

No pneumothorax.

1,973

The lungs are hyperexpanded. A right PICC ends in the mid SVC. There has been interval removal of an enteric tube. There is no pneumothorax. Small bilateral pleural effusions. Patchy opacities at the right lung base is new. Osseous structures are grossly unremarkable.

Patchy opacities at the right lung base may be consistent with aspiration or pneumonia. No pneumothorax.

387

Single portable view of the chest. Enteric tube passes below the diaphragm with tip in the gastric fundus. Low lung volumes are seen with secondary crowding of the bronchovascular markings. No confluent consolidation identified. Cardiomediastinal silhouette is within normal limits.

Endotracheal tube in appropriate position.

4,767

Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. The cardiomediastinal and hilar contours are improving, and are similar to the patient's baseline. There is no pneumothorax, pleural effusion or consolidation. The right-sided internal jugular central venous line ends in the cavoatrial junction.

No pneumothorax. Right-sided internal jugular central venous line ends in the cavoatrial junction.

3,210

Lungs are expanded and clear. No pleural abnormality. Heart size is top-normal. Cardiomediastinal hilar silhouettes are unremarkable. A Dobhoff tube terminates in the gastric fundus.

No evidence of acute cardiopulmonary abnormality.

12,282

An enteric tube extends below the diaphragm with the tip out of view of this film. The heart size is normal. The hilar and mediastinal contours are normal. Evaluation of the left lung is limited due to technique, however the right lung is unremarkable. The visualized subdiaphragmatic bowel appears to be distended, consistent with patient's known small bowel obstruction.

NG tube extends below the diaphragm, with the tip out of view of this film.

17,547

Mild pulmonary edema is present. Left lower lung opacity is likely a combination of small atelectasis and probably a small effusion. Right small pleural effusion is presumed. Heart size is mildly enlarged, and the pulmonary vasculature is minimally congested. A right central line tip ends at lower SVC.

Mild pulmonary edema. Left lower lung opacity is likely a combination of atelectasis and effusion and right lung base atelectasis is minimal. There is no evidence of pneumothorax.

17,182

Frontal view of the chest was obtained. Leads of a left-sided pacer terminate in the right atrium and ventricle. Moderate cardiomegaly with calcification of the aortic knob are stable. Hyperinflated lungs are consistent with chronic obstructive pulmonary disease. Interstitial lung markings are increased, consistent with mild pulmonary edema. Retrocardiac and right lung base opacities may represent a combination of atelectasis and effusion.

Mild pulmonary edema with bibasilar atelectasis. Stable moderate cardiomegaly.

16,947

There are diffuse airspace opacities spanning nearly the totality of both lungs, with some sparing of an ill-defined region in the right upper lung. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.

Bilateral opacities occupying nearly the totality of the lungs consistent with acute pulmonary edema. Diffuse reactive inflammatory process such as pneumonitis or infection cannot be excluded.

18,457

There has been interval removal of the malpositioned Dobbhoff tube. There is no evidence of pneumothorax. Small bilateral pleural effusions are likely. The cardiomediastinal and hilar contours are normal. Lung volumes are low, but there is no focal consolidation concerning for pneumonia. Right PICC line is again noted, tip terminating in the mid SVC. The upper abdomen is unremarkable in appearance.

Interval removal of the malpositioned Dobbhoff tube with no evidence of pneumothorax or other complication.

19,194

AP portable upright view of the chest provided. No free air below the right hemidiaphragm. Lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact.

No evidence of free air below the right hemidiaphragm.

3,294

Other support and monitoring devices remain stable. The right pleural effusion and pulmonary edema are improved, specifically the right middle lobe opacity which may have been due to asymmetric edema or aspiration has improved. There remains pneumoperitoneum which may be increasing. Additionally, there is new left soft tissue emphysema.

Stable to increasing pneumoperitoneum with new left-sided subcutaneous emphysema. These findings raise concern about appropriate functionality of the gastrostomy tube. telephone on . Improved pulmonary edema.

15,287

The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. . No pneumonia, no pulmonary edema. No pleural effusions.

Normal chest radiograph without pneumonia.

19,004

Lung volumes are low, resulting in bronchovascular crowding, but the appearance of the lungs is otherwise unremarkable for supine positioning. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation.

No acute cardiopulmonary process. Although no acute fracture or other chest wall lesion is seen, conventional chest radiographs are not sufficient for detection or characterization of most such abnormalities. If the demonstration of trauma to the chest wall is clinically warranted, the location of any referrable focal findings should be clearly marked and imaged with either bone detail radiographs or Chest CT scanning.

9,446

Again is seen a left-sided double-lumen central venous catheter with tip at the lower SVC. The cardiomediastinal and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax. An IVC filter is in place.

No acute cardiopulmonary process.

2,300

The patient is mildly rotated. Right PICC tip terminates in the upper SVC. The cardiac, mediastinal and hilar contours are unchanged, and the heart size is normal. Lungs are clear. No pleural effusion, focal consolidation or pneumothorax is identified. No acute osseous abnormality seen.

No acute cardiopulmonary abnormality.

10,608

Increased left lower lobe opacification is suggestive of infectious focus. The left heart border is not well-visualized. No pleural effusions. Right Port-A-Cath terminates in the right atrium. No pneumothorax.

Left lower lobe and lingular pneumonia. A. by , M. D.

12,824

Lung volumes are low with vascular crowding but there is no definite new consolidation to suggest pneumonia. Cardiomediastinal silhouette remains stable. Support devices are unchanged.

No acute pneumonia.

5,781

Portable semi-upright radiograph of the chest demonstrates low lung volumes. The cardiac silhouette is stable. No focal consolidation is identified. There are possible small pleural effusions. A right-sided venous catheter terminates in the mid SVC.

No CHF or pneumonia. Possible small pleural effusions.

15,995

The cardiac silhouette remains enlarged. The aorta calcified and tortuous. No pleural effusion or pneumothorax is seen. No overt pulmonary edema is. Patchy right base opacity most likely represents overlap of vascular structures although early pneumonia is not excluded in the appropriate clinical setting.

Patchy right base opacity most likely represents overlap of vascular structures although early pneumonia is not excluded in the appropriate clinical setting.

1,892

The lungs are well expanded and clear. There is stable cardiomegaly. There is no pneumothorax or pleural effusion. There is DJD at both shoulders.

No acute cardiopulmonary process.

18,481

Endotracheal tube tip is just above carina, should be pulled back. Endotracheal tube tip is well below diaphragm. Shallow inspiration. There are left basilar nodular opacities, consider pneumonitis, possibly aspiration, or atelectasis. Right lung is clear. .

Endotracheal tube tip just above carina, should be pulled back. Left basilar opacities, consider pneumonitis, aspiration, or atelectasis.

1,695

Since , moderate to severe pulmonary edema has worsened and severe cardiomegaly is unchanged. No pneumothorax. Small pleural effusions are presumed but unchanged. Median sternotomy wires are intact and aligned.

Worsening moderate to severe pulmonary edema with unchanged severe cardiomegaly.

19,944

Single portable chest radiograph was provided. Lung volumes are low. Streaky retrocardiac and right lower lobe opacities are likely atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is unchanged. Clips and spinal hardware are incompletely visualized in the lumbar spine.

Low lung volumes and atelectasis, otherwise no acute process.

11,358

Single frontal view of the chest demonstrates a prominent cardiac silhouette, likely accentuated by AP technique. The mediastinal and hilar contours are within normal limits. There is new increased left greater than right bibasilar opacities, which could reflect developing pneumonia in the appropriate clinical setting, alternatively aspiration could have a similar appearance. There may be trace left effusion. There is no pneumothorax. Pulmonary vascular congestion is mild.

New left greater than right bibasilar opacities could reflect infection versus aspiration.

19,050

Increased bilateral symmetric central pulmonary opacities seen. Name compatible with increased pulmonary edema.

Increased pulmonary edema

18,656

Single frontal view of the chest was obtained. Tracheostomy tube is in similar position to prior. Moderate cardiomegaly and cardiomediastinal contours are stable. Increased right base consolidative opacity is compatible with pneumonia or aspiration. Left base opacity could represent atelectasis or consolidation. No substantial pleural effusion or pneumothorax.

Right base consolidative opacity and patchy left base opacity are compatible with pneumonia or aspiration. Moderate cardiomegaly.

19,956