Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Bilateral lung apices are obscured by patient 's head . Right upper lung is obscured by an overlying hand . Allowing for the limitations , there is no consolidation . Blunting of left costophrenic angle may be a small pleural effusion . Cardiomediastinal silhouette is difficult to evaluate due to optimal positioning .
    OUTPUT:
    
Exam is limited due to poor patient positioning . Allowing for limitations , there is no radiographic evidence of pneumonia .