Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . The aorta is diffusely calcified . A small hiatal hernia is again noted . Pulmonary vasculature is normal . Lungs are slightly hyperinflated . Blunting of the right costophrenic angle is relatively unchanged , and could reflect a trace right pleural effusion or pleural thickening . No focal consolidation , left pleural effusion or pneumothorax is present . Minimal scarring is noted in the lung apices . Extensive fusion hardware within the thoracolumbar spine is noted . Multiple sutures are seen within the right lateral abdomen .
    OUTPUT:
    
Unchanged blunting of the right costophrenic angle , may reflect pleural thickening or trace pleural effusion . Small hiatal hernia .