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<s>[INST] the heart is normal in size. there is a moderate sized hiatal hernia. otherwise, the mediastinal and hilar contours appear within normal limits. lung volumes are low. lungs appear clear. no fracture is identified.What are the key findings of this report? [/INST] hiatal hernia. no evidence of acute cardiopulmonary disease. </s>

<s>[INST] the lungs are clear without consolidation, effusion, or edema. there is new enlargement of the right hilum with increased soft tissue projecting over the lower right paratracheal region. there is also fullness in the ap window. cardiac silhouette is within normal limits. no acute osseous abnormalities.What are the key findings of this report? [/INST] enlarged right hilum, fullness of the ap window and increased density projecting over the right partracheal region. chest ct is suggested to further evaluate for suspected underlying adenopathy. </s>

<s>[INST] 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.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>

<s>[INST] there has been interval removal of a left chest tube. there is no pneumothorax. there is stable elevation of the right hemidiaphragm with associated platelike atelectasis. there is no pleural effusion, pulmonary edema, or focal consolidation. the cardiomediastinal silhouette is unchanged. a left pectoral dual-chamber pacemaker and its leads project in unchanged location.What are the key findings of this report? [/INST] <num>. status post removal of the left chest tube without evidence of pneumothorax. <num>. low lung volumes without evidence of acute cardiopulmonary process. </s>

<s>[INST] single portable view of the chest. low lung volumes are again seen. vague opacity projects over the anterior right <num>nd rib compatible with healing fracture seen on prior ct scan. the lungs are otherwise clear. cardiac silhouette is slightly enlarged but likely accentuated due to low lung volumes. left chest wall single lead pacing device is again noted.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] previously visualized right medial basal parenchymal opacity has increased in comparison to the prior study. additionally, there is new increased opacification of the left lower lobe. these findings are most suggestive of an infectious process, possibly due to aspiration. cardiac and mediastinal silhouettes remains stable with moderate cardiomegaly. no large pleural effusion is identified but there is blunting of bilateral hemidiaphragms and small pleural effusions may be present. no pneumothorax.What are the key findings of this report? [/INST] worsening of previously visualized right medial basal parenchymal opacity with new opacification of the left lower lobe. these findings are suspicious for worsening bibasilar infectious process, possibly due to aspiration. </s>

<s>[INST] low lung volumes accentuate the cardiac silhouette and bronchovascular structures. considering this factor, heart size is upper limits of normal. lungs are grossly clear on the pa view. localized opacity in the infrahilar region the lateral view is probably due to confluence of vascular structures accentuated by the low lung volumes.What are the key findings of this report? [/INST] <num>. no radiographic evidence of pneumonia or congestive heart failure. <num>. infrahilar opacity on lateral radiograph, most likely due to superimposition of vascular structures accentuated by low lung volumes. repeat lateral radiograph with improved technique is suggested to confirm this impression and to exclude the possibility of a nodule or mass in this region. </s>

<s>[INST] there is no focal consolidation, pleural effusion or pneumothorax. the heart size is mildly enlarged. the imaged upper abdomen is unremarkable. the bones are intact.What are the key findings of this report? [/INST] no acute cardiopulmonary process. mild cardiomegaly. </s>

<s>[INST] cardiac silhouette size is normal. the aorta is tortuous. the mediastinal and hilar contours otherwise are unremarkable. pulmonary vasculature is normal. apart from subsegmental atelectasis within the right middle lobe, the lungs are clear without focal consolidation, pleural effusion or pneumothorax. rounded opacity projecting over the distal clavicle could reflect a bone island or area of heterotopic ossification.What are the key findings of this report? [/INST] no acute cardiopulmonary abnormality. </s>

<s>[INST] pa and lateral views of the chest provided. midline sternotomy wires, mediastinal clips and dual lead pacemaker appear unchanged. a right upper extremity picc line is again seen which appears intervally advanced, with its tip now extending into the cavoatrial junction possibly entering the right atrium. patient is rotated to her left. there is pulmonary edema which is similar to prior exam. small bilateral pleural effusions are likely present. mitral annular calcification noted. cardiomediastinal silhouette stable. no pneumothorax. bony structures are grossly intact with chronic degeneration of the right shoulder partially noted.What are the key findings of this report? [/INST] <num>. pulmonary edema with small pleural effusions. <num>. picc line tip at the cavoatrial junction or within the right atrium. consider slight retraction. </s>

<s>[INST] the lungs are poorly expanded, accounting for bronchovascular crowding. some bibasilar atelectasis is present, but there is no definite focal consolidation. cardiomediastinal contour is unremarkable. there is no pleural effusion or pneumothorax. severe degenerative changes of the right shoulder are re-demonstrated. this study is underpenetrated and suboptiaml for assessment of bony structures. spinal fixation rods and screws are present, without evidence of hardware-related complication. a left-sided picc line has been removed in the interval. there are likely degenerative changes at the right shoulder, not well assessed.What are the key findings of this report? [/INST] bibasilar atelectasis. no evidence of acute cardiopulmonary process. if concern for scapular or other fracture, recommend dedicated imaging of the site. </s>

<s>[INST] frontal and lateral views of the chest are obtained. there is minimal left mid-to-lower lung linear atelectasis/scarring. no focal consolidation, pleural effusion, or pneumothorax is seen. the cardiac and mediastinal silhouettes are stable and unremarkable. multilevel degenerative changes are seen along the spine. old fracture deformities of the posterior left fifth and sixth ribs are again seen.What are the key findings of this report? [/INST] minimal linear scarring/atelectasis of the left mid-to-lower lung. </s>

<s>[INST] frontal and lateral views of the chest were obtained. low lung volumes result in bronchovascular crowding. there is no focal consolidation, pleural effusion or pneumothorax. heart size, mediastinal silhouette and hilar contours are within normal limits allowing for lung volumes. no osseous abnormality is identified. there is no free air under the right hemidiaphragm.What are the key findings of this report? [/INST] no pneumonia, edema or effusion. </s>

<s>[INST] cardiac, mediastinal and hilar contours are normal. the pulmonary vasculature is not engorged. ring-like opacities are noted diffusely within the right upper and mid lung fields as well as within the left lung base likely reflective of diffuse bronchiectasis with airway wall thickening. adjacent patchy opacities may reflect regions of infection. no pleural effusion or pneumothorax is present. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] diffuse bronchiectasis, most pronounced in the right upper and mid lung fields in left lung base, with airway inflammation and adjacent patchy opacities suggestive of infection. </s>

<s>[INST] the heart is moderately enlarged with prominent interstitial markings reflecting pulmonary edema. there is no pleural effusion or pneumothorax. no focal consolidation is seen.What are the key findings of this report? [/INST] cardiomegaly with pulmonary edema. </s>

<s>[INST] there is a <num> cm linear metallic density only seen on the frontal view which projects over the expected site of the right pulmonary hilum. possibility of foreign body is consider though this most likely represents external artifact and clinical correlation is advised. this finding is new from prior study dated <unk>. lungs appear clear though volumes are low. the heart size is within normal limits. the mediastinal contour is normal. the pulmonary vasculature is normal. no pleural effusion or pneumothorax is seen. no bony abnormalities.What are the key findings of this report? [/INST] <num>. linear metallic density projecting over the right pulmonary hilum, new from prior exam, likely external artifact, less likely foreign body. <num>. low lung volumes without definite sign of acute intrathoracic process. </s>

<s>[INST] there is a right upper lobe opacity, similar to the pet ct from <unk>, consistent with radiation changes or metastatic tumor spread. this is significantly progressed since <unk>. the cardiomediastinal silhouette and hila are normal. no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] <num>. no acute cardiothoracic process. <num>. right upper lobe opacity likely due to radiation changes or metastatic tumor spread, unchanged since <unk>. </s>

<s>[INST] frontal and lateral radiographs of the chest demonstrate bibasilar atelectasis and small bilateral pleural effusions. in pulmonary markings and cephalization of pulmonary vasculature is consistent with moderate pulmonary edema. the cardiomediastinal and hilar contours are unchanged. there is no pneumothorax or focal consolidation. the left-sided internal jugular central venous line ends at the cavoatrial junction.What are the key findings of this report? [/INST] <num>. moderate pulmonary edema. <num>. stable appearing cardiomediastinal and hilar contours. </s>

<s>[INST] rotated positioning. left pigtail catheter has been removed. probable small left apical pneumothorax. again seen is patchy opacity at the left lung base, likely a combination of collapse/consolidation and pleural fluid. there is also patchy opacity at the right base, similar to prior. slight upper zone redistribution and vascular plethora is also similar to the prior film. as before, the left hemidiaphragm is elevated.What are the key findings of this report? [/INST] interval removal of left pigtail catheter. probable small left apical pneumothorax. the hydro pneumothorax seen on the <unk> ct is not well appreciated radiographically. otherwise, doubt significant interval change. </s>

<s>[INST] frontal and lateral views of the chest. the lungs are clear. cardiomediastinal silhouette is within normal limits. the aorta is slightly tortuous. no acute osseous abnormality detected.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] the pulmonary vasculature is normal and there is no evidence of central pulmonary vascular congestion. the cardiac silhouette remains mildly enlarged. there are trace bilateral pleural effusions. there is no pneumothorax or focal airspace consolidation. the mediastinal contours are normal. the hilar structures are unremarkable. an aortic valve prosthesis and sternotomy wires are constant.What are the key findings of this report? [/INST] new, small bilateral pleural effusions without overt evidence for pulmonary edema. these findings were discussed with <unk> in the office of dr. <unk> by dr. <unk> at <time> on <unk> at the time of discovery. </s>

<s>[INST] ap and lateral views the chest were provided for review. the heart size is normal. mediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax. there is no focal consolidation concerning for pneumonia.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] the lungs are clear without consolidation or edema. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] frontal and lateral chest radiographs demonstrate intact sternotomy wires and a right internal jugular central catheter with the tip at the cavoatrial junction. a small right pleural effusion is decreased from prior radiograph. a small left pneumothorax is unchanged. no focal opacity concerning for infection is identified.What are the key findings of this report? [/INST] <num>. unchanged small left pneumothorax <num>. small right pleural effusion, improved from radiograph on the day prior. </s>

<s>[INST] ap portable upright view of the chest. the endotracheal tube and orogastric tube are unchanged in position. moderate bilateral pleural effusions are present, slightly worse on the right since the <unk> <time> am examination, with increased right atelectasis. there is no pneumothorax.What are the key findings of this report? [/INST] slightly worsened moderate right pleural effusion with increased adjacent atelectasis. unchanged small left effusion. </s>

<s>[INST] the heart is normal in size. the hilar and mediastinal contours are normal. the lungs are well expanded and clear. there are no pleural effusions or pneumothorax. the osseous structures are unremarkable.What are the key findings of this report? [/INST] no radiographic evidence of an acute cardiopulmonary process. these findings were discussed with dr. <unk> by dr. <unk> <unk> telephone on <unk> at <time>, time of discovery. </s>

<s>[INST] cardiac silhouette size is normal. the mediastinal and hilar contours are unchanged with evidence of prior esophagectomy and gastric pull-through. atherosclerotic calcifications within the aortic arch are re- demonstrated. ill-defined patchy opacities are noted involving the right mid and lower lung fields as well as to a lesser extent within the left lung base, findings which are suspicious for aspiration pneumonia. blunting of the costophrenic angles posteriorly on the lateral view suggests small bilateral pleural effusions, new in the interval. no pneumothorax or pulmonary vascular congestion is present. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] multifocal ill-defined patchy opacities involving the right mid lung field and both lung bases concerning for aspiration pneumonia. new small bilateral pleural effusions. </s>

<s>[INST] a dialysis catheter terminates at the cavoatrial junction. 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.What are the key findings of this report? [/INST] no evidence of acute disease. </s>

<s>[INST] a right internal jugular catheter is present with the tip in the upper svc. a left-sided chest tube is in unchanged position. sternal wires are intact. since the prior exam, the endotracheal tube and nasogastric tube have been removed. the lung volumes are lower, accentuating the bronchovascular structures and pleural effusions. small-to-moderate bilateral pleural effusions are likely just slightly increased in szie. there is associated atelectasis. the apices of lungs are clear. the mediastinal contours are unchanged, with an expected postoperative appearance. the cardiac size is difficult to evaluate given the adjacent effusions.What are the key findings of this report? [/INST] low lung volumes after extubation. slight interval increase in size of bilateral small-to-moderate pleural effusions. </s>

<s>[INST] frontal and lateral views of the chest were obtained. the lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. heart size is normal. mediastinal silhouette and hilar contours are normal.What are the key findings of this report? [/INST] normal chest radiographs. </s>

<s>[INST] mild to moderate atelectasis, left lower lobe, is stable since <unk>, improved substantially since <unk>. cardiomediastinal silhouette is normal. pleural effusion is small if any. esophageal drainage tube ending at or just past pylorus and a feeding tube ending in the upper jejunum are unchanged in their respective positions.What are the key findings of this report? [/INST] stable placement of drainage tube at or just distal to the pylorus and feeding tube terminating in the jejunum. stable residual left lower lobe atelectasis. </s>

<s>[INST] cardiomediastinal contours are stable in appearance. small right upper lobe nodular opacity at level of second anterior rib is similar compared to earlier radiographs. minimal bibasilar opacities are improved compared to prior radiographs. mild elevation of left hemidiaphragm is unchanged. no pleural effusion or acute skeletal findings.What are the key findings of this report? [/INST] no definite acute pneumonia, but ct would be more sensitive for detecting early signs of infection, especially considering the presence of chronic chest radiograph abnormalities in this patient. </s>

<s>[INST] the lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. cardiac and mediastinal silhouettes are normal. no acute fractures are identified.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] one ap view of the chest. the left costophrenic angle is not completely imaged. the previously seen small left pleural effusion is difficult to evaluate. no right pleural effusion. no consolidation or pneumothorax. the cardiomediastinal and hilar contours are normal.What are the key findings of this report? [/INST] previously seen small left pleural effusion is difficult to evaluate due to incomplete imaging of the left costophrenic angle, however, does not appear significantly larger. no evidence of pneumonia. </s>

<s>[INST] the newly placed feeding tube terminates in the stomach. lung volumes are low, contributing to vascular crowding. however, persistent peribronchial cuffing suggests mild pulmonary edema, unchanged. the heart and mediastinum are magnified by the projection. the patient's chin obscures the left lung apex, precluding evaluation for pneumothorax on this side. there is no right pneumothorax.What are the key findings of this report? [/INST] new dobbhoff tube terminates in the stomach. no other significant interval change. </s>

<s>[INST] frontal and lateral views of the chest demonstrate low lung volumes, accentuating perihilar vascular congestion and crowding. the heart is normal in size. post-cabg changes and median sternotomy wires are present. the thoracic aorta is tortuous with arch calcifications. retrocardiac opacity likely represents atelectasis. there is no large pleural effusion or pneumothorax. thoracic kyphosis is unchanged. right shoulder severe deformity is chronic. pronounced left shoulder osteoarthritis is present.What are the key findings of this report? [/INST] <num>. findings suggesting mild perihilar vascular congestion. <num>. left basilar opacity likely reflecting atelectasis; however, if there is persistent evidence of or concern for infection based on clinical grounds, then short-term follow-up radiographs could be considered. </s>

<s>[INST] the heart size is normal. the mediastinal and hilar contours are unremarkable. the pulmonary vascularity is normal. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is identified. there are no acute osseous abnormalities.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] the left-sided chest tube and mediastinal drains have been removed. there is a small left apical pneumothorax. right ij line with tip in the right atrium is again seen. there is volume loss in both lower lungs left greater than rightWhat are the key findings of this report? [/INST] tiny left apical pneumothorax after removal of chest tube. </s>

<s>[INST] there is increasing left-sided pleural effusion with opacification of the left hemithorax. there is a loculated component along the lateral chest wall. there is increased retrocardiac density which may reflect atelectasis. there may be a trace apical pneumothorax. the right hemithorax is clear. osseous structures are notable for a comminuted proximal left clavicle fracture.What are the key findings of this report? [/INST] increasing left-sided pleural effusion with loculated component about the lateral chest wall. hemothorax is not excluded. if further evaluation is required, consider ct. left lower lobe atelectasis. comminuted left proximal clavicle fracture. perhaps trace left apical pneumothorax. </s>

<s>[INST] the lungs are clear. the hilar and cardiomediastinal contours are normal. there is no pneumothorax. there is no pleural effusion. pulmonary vascularity is normal.What are the key findings of this report? [/INST] normal chest. </s>

<s>[INST] mild basilar atelectasis is seen. there is no focal consolidation. there may be an azygos lobe. the cardiac silhouette is top-normal. the aortic knob calcified.What are the key findings of this report? [/INST] mild basilar atelectasis without definite focal consolidation. </s>

<s>[INST] ap upright and lateral views of the chest provided. lung volumes are low and patient is slightly rotated to the right limiting assessment. allowing for this, there is no convincing evidence for pneumonia or edema. no large effusion or pneumothorax is seen. the aorta is calcified and slightly unfolded. heart size appears grossly stable. bony structures appear grossly intact.What are the key findings of this report? [/INST] limited, negative. </s>

<s>[INST] the cardiomediastinal and hilar contours are stable from the prior examination. postoperative changes involving the left hemi thorax and left upper lobe collapse are again noted , there is no pneumothorax or pleural effusion. an endobronchial valve projects over the left hilus as before. aeration of the left lung is much improved. the right lung is hyperinflated, as before.What are the key findings of this report? [/INST] stable postop changes in the left lung. endobronchial valve projects over the left hilus. improved aeration of the left lung </s>

<s>[INST] no significant change in the location of pacing leads. the patient is status post partial resection of a left upper lobe, resulting in hyperinflation. no focal consolidation is seen. heart size is normal. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] no evidence of acute cardiopulmonary process. </s>

<s>[INST] ap and lateral views of the chest. dual-lumen central venous catheter is seen in unchanged position. low lung volumes are noted. since prior, there has been interval decrease in size of the left-sided pleural effusion. the lungs are otherwise clear. mitral valvular replacement is identified. mediastinal surgical clips are identified. no acute osseous abnormality is identified.What are the key findings of this report? [/INST] interval decrease in size of left-sided pleural effusion. otherwise, no change. </s>

<s>[INST] the lungs are clear, the cardiomediastinal silhouette and hila are normal. there is no pleural effusion and no pneumothorax. cervical ribs are seen. there are no rib fractures identified on this chest radiograph; however, dedicated rib series is more sensitive.What are the key findings of this report? [/INST] no acute process including no evidence of rib fractures. </s>

<s>[INST] the cardiomediastinal silhouette is normal. there is no pleural effusion or pneumothorax. patchy and linear right basilar opacity is noted, with mild associated volume loss and otherwise clear lungs. no evidence of focal consolidation. no acute osseous abnormality.What are the key findings of this report? [/INST] patchy and linear right basilar opacity with mild associated volume loss. observed findings may reflect atelectasis and or aspiration. short-term followup radiographs are recommended to assess for resolution. . </s>

<s>[INST] the cardiac silhouette is top-normal. again seen is a transvenous pacemaker with the leads terminating in the right atrium and right ventricle without evidence of mediastinal widening pleural effusions or pneumothorax. mediastinal silhouette is normal. previously seen left lower lobe consolidation is no longer present.What are the key findings of this report? [/INST] no evidence of pneumonia. </s>

<s>[INST] lung volumes are low, accounting for some bronchovascular crowding. no focal opacities are identified. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] low lung volumes. otherwise unremarkable chest radiographic examination. </s>

<s>[INST] right internal jugular venous catheter terminates in low svc. lung volume remains low. left pleural effusion is small. left lower lobe aeration is improved. bibasilar opacities are likely secondary to atelectasis. sternotomy wires are intact. cardiomediastinal silhouette has normal postop appearance.What are the key findings of this report? [/INST] small left pleural effusion is stable. </s>

<s>[INST] frontal and lateral views of the chest were performed. there is opacification involving the right middle and left upper lobes concerning for pneumonia. there is no pleural effusion or pneumothorax. the cardiac silhouette is normal in size. coronary calcifications are noted, otherwise, the mediastinum is normal. the imaged upper abdomen is remarkable for dilated loops of bowel which are better evaluated on the dedicated abdominal radiograph.What are the key findings of this report? [/INST] right middle and left upper lobe opacities worrisome for pneumonia and/or aspiration. followup chest radiographs are recommended to ensure clearance. </s>

<s>[INST] frontal and lateral views of the chest were obtained. dual-lead left-sided pacer device is again seen with leads unchanged in position. the cardiac and mediastinal silhouettes are stable. there is linear left basilar/lingular opacity, most likely due to atelectasis/scarring. no definite focal consolidation is seen. there is no pleural effusion or pneumothorax.What are the key findings of this report? [/INST] left basilar atelectasis without definite focal consolidation. no pulmonary edema. </s>

<s>[INST] <num> portable views of the chest. mixed areas of lucency and sclerosis seen throughout all of the osseous structures compatible with patient's known metastatic disease. there is no definite superimposed consolidation in the lungs noting that visualization is somewhat obscured due to the overlying osseous disease. the cardiomediastinal silhouette is within normal limits. old healed left <num>th rib fracture is identified.What are the key findings of this report? [/INST] no definite acute cardiopulmonary process. diffuse osseous metastases. </s>

<s>[INST] the endotracheal tube terminates approximately <num> cm above the carina. ng tube is in the stomach. heart is upper limits of normal size and mediastinal contours are unremarkable. there is pulmonary vascular congestion and minimal interstitial pulmonary edema. bibasilar atelectasis is worse on the left than the right. small bilateral pleural effusions.What are the key findings of this report? [/INST] <num>. endotracheal tube and nasogastric tube are appropriately positioned. <num>. pulmonary vascular congestion and minimal interstitial edema. </s>

<s>[INST] supine portable ap view of the chest was provided. the endotracheal tube is seen with its tip located approximately <num> cm above the carina. ng tube descends into the left upper abdomen where it is coiled in the expected location of the stomach. the lungs are clear though there is slight volume loss on the left compared with right. patient is also rotated to the left somewhat limiting the evaluation. no large consolidation, effusion or pneumothorax is seen. bony structures are intact.What are the key findings of this report? [/INST] appropriately positioned endotracheal and nasogastric tubes. </s>

<s>[INST] endotracheal tube is seen, terminating <num> cm above the level of the carina. nasogastric tube is seen coursing into the left upper quadrant, terminating in the expected location of the stomach. the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] endotracheal tube terminates approximately <num> cm above the carina. nasogastric tube courses to the expected location of the stomach. clear lungs. </s>

<s>[INST] the left pleural effusion has increased in size, now moderate. otherwise, there is little overall change in the right paramediastinal interstitial abnormality. normal heart size and mediastinal contours. no pneumothorax.What are the key findings of this report? [/INST] increase in size of moderate left pleural effusion. </s>

<s>[INST] frontal and lateral views of the chest were performed. there is no pleural effusion, pneumothorax or focal airspace consolidation. the cardiac and mediastinal contours are normal. the hilar structures and pleural surfaces are unremarkable. the imaged upper abdomen is normal. there are no acute osseous abnormalities. soft tissue swelling is seen anterior to the sternomanubrial junction.What are the key findings of this report? [/INST] soft tissue swelling directly over the sternum which would be amenable to direct physical examination. </s>

<s>[INST] lung volumes are low. bronchovascular markings are prominent. there is no focal consolidation. there is streaky density at the lung bases likely representing subsegmental atelectasis. the right pulmonary hilum remains prominent. the aorta is calcified and tortuous. mediastinal structures are otherwise unremarkable. the bony thorax is grossly intact. allowing for differences in technique, there is no significant change.What are the key findings of this report? [/INST] no acute change. </s>

<s>[INST] compared with prior radiographs on <unk>, lung volumes are improved. there is left basilar linear atelectasis. there is no focal consolidation. no pleural effusion or pneumothorax is seen. streaky appearance over the posterior thorax on the lateral view is likely secondary to external devices. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. stringy appearance over the posterior thorax on the lateral view is likely secondary to external devices, however radiograph should be repeated without external devices on patient. recommendation(s): repeat radiographs without external devices on patient. </s>

<s>[INST] compared to baseline there is a new right middle lobe opacity partially obscuring the inferior right cardiac margin. there is also an opacity in the right costophrenic angle with an associated small pleural effusion better seen in the lateral view. linear atelectasis is seen in the right mid lung. stable moderate-to-severe cardiomegaly. there is no pneumothorax. sternotomy wires are intact.What are the key findings of this report? [/INST] right middle and right lower lobe opacities with associated pleural effusion may represent a combination of atelectasis and infection/aspiration in this patient with recent vomiting episodes. </s>

<s>[INST] there has been interval placement of right-sided pigtail catheter. pigtail seen in at the right lung apex with some kinking along the course of the catheter. the right-sided pneumothorax has decreased in size but still persists at the apex. chronic parenchymal changes in the lungs are again noted in fully described on prior report. thoracic dextroscoliosis is again noted.What are the key findings of this report? [/INST] interval placement of right pigtail catheter with some kinking along the course of the catheter, decrease in size of right-sided pneumothorax. </s>

<s>[INST] right pleural effusion with overlying atelectasis appears increased as compared to the prior study right base opacity may be due to pleural effusion and atelectasis underlying consolidation is not excluded. the cardiac silhouette remains enlarged. patient is status post median sternotomy and cardiac valve replacement. there is concern for a small right apical pneumothorax, present on prior studies, but slightly more conspicuous than on the most recent prior.What are the key findings of this report? [/INST] small right apical pneumothorax, present on prior but more conspicuous as compared to the most recent prior study. right base opacity may be due to combination of pleural effusion and atelectasis underlying consolidation is not excluded. persistent enlargement of the cardiac silhouette. </s>

<s>[INST] as compared to chest radiograph from the same day, no free intraperitoneal air on the chest radiograph. lungs are unchanged. right dialysis catheter in the right atrium. no other relevant change.What are the key findings of this report? [/INST] no free intraperitoneal air. </s>

<s>[INST] 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.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>

<s>[INST] pa and lateral images of the chest. the lungs are well expanded. there is pulmonary vascular congestion and prominent interstitial markings consistent with mild pulmonary edema. no focal opacity or mass is seen. small bilateral pleural effusions are noted. there is no pneumothorax. the cardiomediastinal silhouette is enlarged, similar to prior exam.What are the key findings of this report? [/INST] <num>. mild pulmonary edema with small bilateral pleural effusions. <num>. cardiomegaly. </s>

<s>[INST] pa and lateral views of the chest. the lungs are clear without focal consolidation, effusion, or pulmonary vascular congestion. there is no pneumothorax. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormality is identified.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] patient is status post median sternotomy, cabg, and aortic valve replacement. severe cardiomegaly is unchanged. there is mild pulmonary vascular congestion, not substantially changed in the interval without overt pulmonary edema. mediastinal and hilar contours are otherwise unchanged. no focal consolidation, pleural effusion or pneumothorax is present. no acute osseous abnormalities detected.What are the key findings of this report? [/INST] severe cardiomegaly with chronic mild pulmonary vascular congestion. </s>

<s>[INST] pa and lateral views of the chest were provided. midline sternotomy wires, dual lead pacer appear unchanged from prior with pacer leads extending to the region of the right atrium and right ventricle. there is stable mild cardiomegaly with small bilateral pleural effusions slightly decreased from prior exam. there is no evidence of pneumonia or pulmonary edema. mediastinal contour is stable. bony structures appear intact.What are the key findings of this report? [/INST] small bilateral pleural effusions. no pneumonia. </s>

<s>[INST] the heart size is normal. the mediastinal and hilar contours are unremarkable. the pulmonary vascularity is normal. no focal consolidation, pleural effusion or pneumothorax is identified. left <unk> and <unk> lateral rib fractures are noted. other known fractures involving the left-sided ribs are not clearly delineated on the current exam. old right tenth rib fracture is redemonstrated. multilevel degenerative changes are seen in the thoracic spine.What are the key findings of this report? [/INST] fractures of the left lateral <unk> and <num>th ribs. other known left-sided fractures are not clearly delineated on this current exam. a dedicated rib series can be obtained for further evaluation. no acute cardiopulmonary abnormality. </s>

<s>[INST] unchanged left retrocardiac opacity, likely atelectasis. there is mild cardiomegaly with no pulmonary edema. unchanged small left pleural effusion. there is no pneumothorax.What are the key findings of this report? [/INST] no change from <unk>. </s>

<s>[INST] frontal and lateral radiographs of the chest demonstrate persistent moderate-sized right-sided pleural effusion with adjacent atelectasis, and tiny left-sided pleural effusion. multiple nodular opacifications are seen in the bilateral lungs, which are unchanged from the prior study. the cardiomediastinal and hilar contours are unchanged. no pneumothorax.What are the key findings of this report? [/INST] moderate-sized right pleural effusion with adjacent atelectasis. no pneumothorax. </s>

<s>[INST] left chest cardiac device and <num> lead tips, left vad, left pa catheter, right jugular central venous line tip, right pleural drain, <unk> mediastinal drains, and ett are in similar position compared to prior. feeding tube tip and esophageal temperature probe tip are in the stomach. pulmonary vascular congestion is mild. there is mild pulmonary edema, similar to prior. the left costophrenic angle is obscured by the vad. there is no focal consolidation or large effusion. cardiomegaly is mild, as on prior.What are the key findings of this report? [/INST] no large pleural effusions. </s>

<s>[INST] minimal streaky bibasilar airspace opacities may reflect atelectasis, though infection is not fully excluded. no focal consolidation, pleural effusion or pneumothorax is noted. the pulmonary vasculature is not engorged and there is no overt pulmonary edema. the cardiac silhouette is normal in size. the mediastinal and hilar contours are within normal limits.What are the key findings of this report? [/INST] bibasilar streaky opacities, possibly atelectasis but infection is not excluded. </s>

<s>[INST] supine ap portable view of the chest was obtained. there has been interval placement of endotracheal tube, terminating approximately <num> cm below the carina. nasogastric tube is seen coursing below the level of the diaphragm and terminating in the expected location of the distal stomach. the aorta is calcified and tortuous. the cardiac silhouette is not enlarged. paratracheal opacity is again seen as also seen on the prior study. subtle medial right base patchy opacity could relate to aspiration. no pleural effusion or pneumothorax is seen.What are the key findings of this report? [/INST] <num>. endotracheal and nasogastric tubes in appropriate position. <num>. subtle streaky medial right base opacity could relate to aspiration depending on the clinical situation. </s>

<s>[INST] mild cardiomegaly is re- demonstrated. mediastinal contours are unchanged with atherosclerotic calcifications noted at the aortic knob. hilar contours are similar. lungs are hyperinflated with patchy bibasilar airspace opacities noted, worse since the previous study. a small left pleural effusion is not excluded. no pulmonary edema is seen. there is biapical pleural scarring. multilevel degenerative changes are noted in the thoracic spine.What are the key findings of this report? [/INST] worsening bibasilar airspace opacities which may reflect increased atelectasis though aspiration or infection are not excluded. a small left pleural effusion may be present. </s>

<s>[INST] pa and lateral views of the chest provided. lungs are clear. there is no focal consolidation, effusion, or pneumothorax. there is a subtle linear density abutting the left heart border most likely representing atelectasis or scarring, unchanged from a prior ct from <unk>. the cardiomediastinal silhouette is normal. a coronary stent projects over the heart. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>

<s>[INST] the endotracheal tube and nasogastric tubes have been removed. the lungs are clear. the cardiomediastinal silhouette is unremarkable. no interstitial edema. no pneumothorax.What are the key findings of this report? [/INST] no acute cardiopulmonary process to explain acute fever. </s>

<s>[INST] the lungs appear clear. the cardiac silhouette is moderatly enlarged. no pleural effusions or pneumothoraces. pulmonary vasculature is normal. bones are intact.What are the key findings of this report? [/INST] moderate cardiomegaly without other signs of heart failure. </s>

<s>[INST] mild bibasilar atelectasis is noted, left greater than right. the lungs are otherwise grossly clear without lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. multiple, known, punctate calcified granulomas are better assessed on the patient's prior chest ct dated <unk>. the cardiomediastinal silhouette is grossly within normal limits.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] the lung volumes are low, which limits evaluation. there is mild vascular congestion without overt edema, unchanged from the prior exam. there is no focal consolidation, pleural effusion, or pneumothorax. the mediastinal contours are normal. the heart size is at the upper limits of normal, and unchanged.What are the key findings of this report? [/INST] stable mild vascular congestion without overt edema or evidence of pneumonia. </s>

<s>[INST] portable ap upright chest radiograph is obtained. the heart is mildly enlarged and the aorta is unfolded though overall appearance is unchanged. there are no overt signs of pulmonary edema. there is mild retrocardiac opacity which could represent left lower lobe atelectasis though given underpenetrated technique, evaluation is limited. there is no large effusion or pneumothorax. clips are noted in the right neck, again similar to prior exam. bony structures are intact.What are the key findings of this report? [/INST] mild cardiomegaly with possible left lower lobe atelectasis. no overt signs of pneumonia or edema. </s>

<s>[INST] lung volumes remain low on the right side with a presumed right pleural effusion. there is associated atelectasis and superimposed infection cannot be excluded. there is a new, smaller left-sided pleural effusion. the bilateral upper lobes appear grossly clear. assessment of the cardiomediastinal contour is limited. vascular calcification in the thoracic aorta and mitral valve again noted. no pneumothorax seen.What are the key findings of this report? [/INST] right basal pleural effusion with associated compressive atelectasis. superimposed infection cannot be excluded. small left pleural effusion. </s>

<s>[INST] 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.What are the key findings of this report? [/INST] no acute intrathoracic process. </s>

<s>[INST] the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.What are the key findings of this report? [/INST] no acute cardiopulmonary process. </s>

<s>[INST] lung volumes are low. bilateral pulmonary opacities most likely due to moderate pulmonary edema. there is no pneumothorax or pleural effusions. the cardiac mediastinal silhouette is top-normal, unchanged from the prior exam. the visualized number abdomen is unremarkable. the bones are intact.What are the key findings of this report? [/INST] interval development of moderate pulmonary edema. recommend repeat radiograph after diuresis to exclude underlying infection. </s>

<s>[INST] the lungs are clear of confluent consolidation. costophrenic angles are sharp. cardiac silhouette is enlarged. there is possible mild pulmonary vascular congestion.What are the key findings of this report? [/INST] cardiomegaly. possible mild pulmonary vascular congestion. </s>

<s>[INST] lung volumes are extremely low accentuating the cardiac silhouette and pulmonary vasculature. within this context, heart size is likely normal. cardiomediastinal silhouette and hilar contours are otherwise unremarkable. bibasilar opacities are present, likely representing atelectasis. no large pleural effusion or pneumothorax.What are the key findings of this report? [/INST] extremely low lung volumes with bibasilar opacities likely representing atelectasis, though pneumonia cannot be excluded. recommendation(s): consider repeat examination with better inspiration and lateral view, if possible. </s>

<s>[INST] ap portable supine view of the chest. et tube is noted with its tip approximately <num> cm above the carinal. a spiculated mass projects over the right pulmonary hilum likely representing primary malignancy. there has been interval increase in scattered bilateral pulmonary opacities most notable in the right upper lobe, likely representing progression of pneumonia given rapid interval change.What are the key findings of this report? [/INST] increased opacities primarily in the right upper lobe likely progression in pneumonia. right hilum spiculated mass concerning for primary malignancy. endotracheal tube positioned appropriately. </s>

<s>[INST] lung volumes are low, and bibasilar platelike atelectasis is again noted. the upper lung fields are grossly clear. there is no large pleural effusion, pneumothorax, or pulmonary edema. mild cardiomegaly is stable allowing for low lung volumes. interval removal of a right-sided ij cvl.What are the key findings of this report? [/INST] low lung volumes and bibasilar atelectasis. </s>

<s>[INST] the lungs are hyperinflated, though the diaphragms are not flattened. the heart is not enlarged. blunting of the right heart border seen only on frontal radiograph likely reflects a mediastinal fat pad. the patient's known mediastinal mass, seen on multiple prior ct scans, is not well delineated radiographically. the aorta is mildly unfolded. there is minimal subsegmental atelectasis and/or scarring. no frank consolidation or gross effusion identified. possible trace right pleural effusion. small calcified and noncalcified nodules seen on prior cts are not well delineated radiographically. old healed right-sided rib fractures noted. degenerative changes in the thoracic spine noted.What are the key findings of this report? [/INST] equivocal trace right pleural effusion and minimal atelectasis. otherwise, no acute pulmonary process identified. </s>

<s>[INST] since <unk>, extensive pulmonary edema is mildly improved. superimposed pneumonia cannot be excluded in the appropriate clinical setting. small bilateral pleural effusions and moderate bibasilar atelectasis persist. lung volumes are low. heart size is unchanged. the tip of the endotracheal tube is seen <num> cm above the carina. the tip of a new left picc line is seen in the lower svc. the proximal end of the left picc, adjacent to the lateral edge of the <unk> anterior rib, appears kinked. a feeding tube is seen in the stomach and continues out of view. no pneumothorax.What are the key findings of this report? [/INST] <num>. extensive pulmonary edema is mildly improved since <unk>. superimposed pneumonia cannot be excluded in the right clinical setting. <num>. the proximal end of the left picc line, adjacent to the lateral edge the second anterior rib, appears kinked. </s>

<s>[INST] frontal and lateral radiographs of the chest demonstrate hyperinflated, clear lungs. the cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax, pleural effusion, or consolidation.What are the key findings of this report? [/INST] hyperinflated lungs, suggestive of copd. no acute cardiopulmonary process. </s>

<s>[INST] the heart size is within normal limits as are the mediastinal contours. the lung volumes are low but show no lobar consolidation. again, a small amount of pleural fluid is seen tracking along the right lateral pleural space. clips in the gallbladder fossa represent prior cholecystectomy with couple of dropped clips sitting just at the dome of the liver. a plastic cbd stent is also present. there is no pneumothorax.What are the key findings of this report? [/INST] low lung volumes and small right pleural effusion. </s>

<s>[INST] cardiomediastinal contours are normal. small to moderate right and small left pleural effusions with adjacent atelectasis are stable. mild vascular congestion is stable . there is no pneumothorax . the osseous structures are unremarkableWhat are the key findings of this report? [/INST] stable bilateral effusions with adjacent atelectasis </s>

<s>[INST] in comparison to the prior radiograph on <unk>, there are diffuse interstitial opacities, more notable in the right hemithorax, likely representing moderate asymmetric pulmonary edema. no substantial pleural effusion. no pneumothorax. mild cardiomegaly is stable. median sternotomy wires are intact. no acute osseous abnormalities identified.What are the key findings of this report? [/INST] moderate pulmonary edema. </s>

<s>[INST] frontal and lateral views of the chest were obtained. there are relatively low lung volumes. no definite focal consolidation is seen. there is no pleural effusion or pneumothorax. the right humeral head appears inferiorly subluxed related to the glenoid fossa; correlate clinically. cardiac and mediastinal silhouettes are stable. degenerative changes are seen along the spine.What are the key findings of this report? [/INST] <num>. right humeral head appears inferiorly subluxed in relation to the glenoid, indeterminate age. clinical correlation advised. <num>. low lung volumes. otherwise, no acute cardiopulmonary process. </s>

<s>[INST] retrocardiac opacity containing air bronchograms is concerning for pneumonia. mild atelectasis at the right lung base noted. there are small bilateral pleural effusions. moderate cardiomegaly appears unchanged. no pneumothorax is identified. no free air below the right hemidiaphragm.What are the key findings of this report? [/INST] <num>. left lower lobe pneumonia. <num>. moderate cardiomegaly. small bilateral pleural effusions. </s>

<s>[INST] low lung volumes exaggerate mediastinal and pulmonary vascular caliber. lungs are probably clear. the cardiac silhouette is normal size. there is no pleural abnormality or free subdiaphragmatic gas.What are the key findings of this report? [/INST] normal chest. </s>

<s>[INST] the cardiac silhouette size remains moderately enlarged with a large hiatal hernia re- demonstrated. the mediastinal and hilar contours are stable. calcifications projecting over the left upper lung field are unchanged, and demonstrated on the prior chest cta to be within the left upper anterior chest wall. patchy opacity is noted within the right lung base, with minimal blunting of the right costophrenic sulcus suggestive of a trace pleural effusion. no pulmonary vascular congestion is present. hyperinflation of the lungs is noted. the patient is status post left mastectomy. no acute osseous abnormalities are seen.What are the key findings of this report? [/INST] patchy right basilar opacity with minimal blunting of the right costophrenic angle may be suggestive of atelectasis or infection with a trace right pleural effusion. large hiatal hernia. unchanged calcifications within the left upper anterior chest wall, better demonstrated on the prior ct. </s>