Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable upright chest radiograph ___ at 04 : 13 is submitted .
    OUTPUT:
    
Right internal jugular central line has its tip in the distal SVC . There has been interval removal of the endotracheal tube and nasogastric tube . The heart remains stably enlarged . There is a stable layering left effusion with associated retrocardiac airspace opacity suggestive of atelectasis , although pneumonia can not be excluded . Smaller right effusion and adjacent atelectasis is also again seen . Interval appearance of mild perihilar and interstitial edema . No pneumothorax . Marked degenerative changes of both shoulder joints suggesting chronic rotator cuff tears , right greater than left .