Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is blunting of the left lateral costophrenic angle which is new since prior . Lung volumes are low . Persistent elevation of left hemidiaphragm is again seen . Cardiomediastinal silhouette is unchanged . No acute osseous abnormalities identified . Vertebroplasty changes are again identified in the lumbar spine .
    OUTPUT:
    
New small left effusion . Otherwise , no change .