Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is at the upper limits of normal . Cardiomediastinal silhouette is otherwise within normal limits . Within the limits of plain film radiography , no hilar or mediastinal lymphadenopathy is detected . The clavicular companion shadows are not well demarcated . No CHF , focal infiltrate or effusion is identified . Minimal degenerative narrowing and spurring in the mid thoracic spine is noted .
    OUTPUT:
    
Heart size at the upper limits of normal . Allowing for this , no acute pulmonary process identified . No CHF or pleural effusions . Non-visualization of the clavicular companion shadows ( normal soft tissue contour along the superior edge of the clavicles ) . While this may be an artifact due to overlying soft tissues , clinical correlation to exclude supraclavicular lymphadenopathy ( which can be a source of nonvisualization of the companion shadow ) is requested .