Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Even allowing for small amount of the patient rotation , the trachea and carina appear displaced to the right . The mediastinal borders are not well - defined due to parenchymal changes in both lungs . The left hemidiaphragm is elevated , with underlying gas . The significance of this speckled gas seen in this area is uncertain . There is a probable small left effusion . Patchy opacity in the right mid and lower zones is noted and the possibility of a small effusion can not be excluded . The presence of consolidation would be quite difficult to assess in this setting . There is upper zone redistribution , suggesting an element of CHF .
    OUTPUT:
    
1 . Parenchymal opacities in both lungs , obscuring the mediastinum , but there is suggestion of considerable rightward shift of the mediastinum . 2 . The left hemidiaphragm is elevated . 3 . CHF and small effusions are likely present . 4 . The possibility of underlying consolidation would be difficult to exclude in this setting . If clinically indicated , chest CT may help for further assessment .