Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Study is slightly limited due to patient positioning . Tracheostomy tube is in standard position . Heart size is moderately enlarged . The mediastinal contours are unchanged . Streaky patchy opacities in the lung bases likely reflect atelectasis . There is crowding of the bronchovascular structures likely due to low lung volumes . Trace blunting of the right costophrenic angle may suggest the presence of a trace pleural effusion . No left - sided pleural effusion is identified , and there is no pneumothorax . Multilevel degenerative changes are seen within the thoracic spine , as well as within the right glenohumeral joint .
    OUTPUT:
    
Limited exam due to patient rotation . Streaky bibasilar airspace opacities could reflect atelectasis . Pneumonia can not be completely excluded . Possible trace right pleural effusion .