Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs remain hyperinflated . Blunting of the right costophrenic angle suggests a small pleural effusion . No definite focal consolidation is seen . The cardiac silhouette is moderately enlarged . Mediastinal contours are unremarkable . Biapical pleural thickening is seen . No evidence of pneumothorax is seen . Old mid left clavicular fracture is seen . Also old left - sided rib deformity . Severe degenerative change at the right glenohumeral joint with high - riding right humeral head concerning for rotator cuff disease . Right acromioclavicular joint degenerative change .
    OUTPUT:
    
Small right pleural effusion with overlying atelectasis . COPD . Cardiomegaly .