CXR (PA View) - Systematic Interpretation

Technical Adequacy

• Projection: PA erect view
• Rotation: Mild rightward rotation (asymmetric clavicular heads relative to spinous processes)
• Inspiration: Suboptimal - approximately 8 posterior ribs visible (ideally 9-10), causing mild crowding of bronchovascular markings in lower zones
• Exposure/Penetration: Adequate - thoracic vertebrae visible through cardiac silhouette

Systematic Findings

• Mild thoracic scoliosis with right convexity
• Ribs, clavicles, and scapulae intact - no fractures or lytic lesions
• Normal chest wall soft tissue; female breast shadows overlying lower lung fields

• Trachea midline superiorly; slight rightward deviation distally (related to scoliosis and prominent aortic arch)
• Mediastinum not widened
• Aortic knob is prominent with mild wall calcification - consistent with degenerative/atherosclerotic change

• Cardiothoracic ratio within normal limits (<50%)
• Left and right cardiac borders well-defined
• No cardiomegaly

• Both hila normal in size and density
• No hilar lymphadenopathy or mass

• Mild diffuse increase in interstitial markings in mid-to-lower zones bilaterally - likely accentuated by low lung volumes, but cannot fully exclude mild chronic bronchitic change
• No focal consolidation, nodule, or mass
• No pneumothorax

• Both hemidiaphragms smooth and well-defined; right appropriately higher than left
• Both costophrenic angles are sharp and clear - no pleural effusion
• Normal gastric air bubble under left hemidiaphragm; no sub-diaphragmatic free air

Impression

1. Mild thoracic scoliosis (right convexity)
2. Suboptimal inspiratory effort - crowding of lower zone markings
3. Prominent, mildly calcified aortic arch - age-related atheromatous change
4. No acute cardiopulmonary pathology - no consolidation, effusion, pneumothorax, or cardiomegaly

Note: This interpretation is AI-assisted and should be correlated with the patient's clinical history, symptoms, and reviewed by a qualified radiologist for formal reporting. The image appears to be photographed off a lightbox/monitor rather than a direct digital export, which may reduce fine detail.

Left URS + DJ Stenting - Operative Note Interpretation

Transcription (as written)

Interpreted Operative Summary

1. Cystoscopy done - initial bladder visualization via cystoscope
2. @ UVJ dilated - the left Ureterovesical Junction (UVJ) was found dilated (likely due to the impacted/obstructing stone or as a result of prior obstruction)
3. URS passed - ureteroscope successfully advanced up the left ureter
4. Stone fragmented + removed - stone broken up (likely with laser/pneumatic lithotripsy) and fragments removed
5. 5/26 DJ kept - a Double-J ureteral stent (5 French, 26 cm) placed and retained for post-operative ureteral drainage and healing
6. Foleys passed - Foley urinary catheter placed
7. Pt. comfortable - patient hemodynamically stable and comfortable at end of procedure

Clinical Notes

• The DJ stent (5Fr/26cm) is standard sizing for a ureter of average length
• Post-URS stenting is routine to prevent ureteral edema-related obstruction and allow stone fragment passage
• The note of "UVJ dilated" suggests the stone was likely a distal ureteric stone at or near the UVJ
• Foley catheter placement post-procedure is standard for monitoring urine output and drainage

Note: The AI read the note as mentioning the right side ("Rt UVJ dilated"), but the user specifies this was a Left URS, so "@ UVJ dilated" refers to the left UVJ. The handwriting may have been ambiguous in that regard.