Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is moderate enlargement of cardiac silhouette . The aorta is tortuous . The pulmonary vascularity is not engorged . There is eventration of left hemidiaphragm . There is blunting of the left costophrenic angle on the frontal view suggestive of a small effusion or pleural thickening . No focal consolidation or pneumothorax is present . There are multiple old bilateral rib fractures . Multilevel degenerative changes are present within the thoracic spine .
    OUTPUT:
    
Blunting of left costophrenic angle could suggest a small pleural effusion or pleural thickening . No radiographic evidence for pneumonia or congestive heart failure .