Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral chest radiographs demonstrate leftward patient rotation and low lung volumes with associated accentuation of cardiomediastinal contours and crowding of bronchovascular structures . Left costophrenic angle and lateral aspect of left hemidiaphragm are obscured . There is no pneumothorax . There may be a small left pleural effusion . The visualized upper abdomen is unremarkable .
    OUTPUT:
    
1 . Obscuration of lateral left hemidiaphragm contour and adjacent costophrenic angle , possibly due to the affects of leftward patient rotation . Left pleural effusion and or peripheral pneumonia are difficult to exclude in this region , and a repeat nonrotated radiograph with improved lung volumes may be helpful for further assessment when the patient 's condition permits .