Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Assessment is somewhat limited due to patient rotation . The lung volumes are hyperinflated with flattening of the diaphragms . Findings are suggestive of underlying COPD . The heart size remains mildly enlarged . The aortic knob is calcified . Mild pulmonary vascular engorgement is present , but improved compared to the prior exam . Blunting of the costophrenic angles posteriorly suggest trace bilateral pleural effusions . No pneumothorax or focal consolidation is present . Wedge compression deformity of a mid thoracic vertebral body , deformity of the right proximal humerus , and right sided rib fractures are again noted
    OUTPUT:
    
Mild pulmonary vascular congestion , somewhat improved compared to the prior exam , with trace bilateral pleural effusions .