Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The tracheostomy tube position can not be confirmed on this exam . Again seen is extensive subcutaneous emphysema in the lateral chest wall , pectoralis muscles and cervical regions bilaterally , overall slightly improved compared to the prior exam . There is mild pneumomediastinum , overall improved compared to the prior exam . Underlying coarse interstitial pulmonary markings are again noted . There appears to be bilateral unchanged diffuse reticulonodular interstitial process with a more focal airspace confluent opacity at the right apex . The lungs remain hyperinflated . The cardiac and mediastinal contours are otherwise stable . Chain sutures at the left apex are again noted . Again noted is pneumomediastinum . The right basilar pneumothorax appears to have improved compared to the prior exam . There are probable small bilateral pleural effusions .
    OUTPUT:
    
Tracheostomy position can not be confirmed on this single - view study . Slight interval improvement in the pneumothorax compared to the prior exam .