Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is top normal . Mediastinal and hilar contours are unchanged . There is no pulmonary vascular congestion . There is a small right pleural effusion with chronic elevation of the right hemidiaphragm , unchanged compared to the previous exam . Right basilar atelectasis is again demonstrated . No left - sided pleural effusion or pneumothorax is present . There are multiple old left - sided rib fractures . Multilevel degenerative changes are visualized in the thoracic spine . Chronic left AC joint dislocation is re - demonstrated .
    OUTPUT:
    
Relatively unchanged exam with continued small right pleural effusion , chronic elevation of the right hemidiaphragm and right basilar atelectasis .