Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe roto scoliosis and rib cage deformity limits the evaluation of the lungs . Cardiac size is top normal . The upper lungs are clear . There is no pneumothorax . Suspected small bilateral pleural effusions are associated with adjacent atelectasis . Spinal hardware is noted .
    OUTPUT:
    
No acute cardiopulmonary abnormality