Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The mediastinal and hilar contours are unchanged . There are increased interstitial markings with hyperinflation and emphysematous changes . Small bilateral pleural effusions are noted , greater on the left , with adjacent left basilar opacity likely reflective of atelectasis . Infection can not be completely excluded . There is no overt pulmonary edema or pneumothorax . Multilevel degenerative changes are noted in the thoracic spine . Remote left - sided rib fractures are noted .
    OUTPUT:
    
Small bilateral pleural effusions , greater on the left , with adjacent left basilar opacity , possibly atelectasis though infection can not be completely excluded . Emphysema with chronic interstitial lung disease .