Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low . Bilateral pleural effusions are probably moderate in size with likely adjacent relaxation atelectasis . Concurrent pneumonia in the lower lobes can not be completely excluded in the appropriate clinical situation , difficult to assess on this exam in the setting of effusions . The heart size is difficult to assess in the setting of these pleural effusions , however heart size is probably top normal . No frank pulmonary edema . Aortic knob calcifications are mild . Left shoulder replacement is partially imaged . Bilateral mild degenerative changes at the acromioclavicular joints are noted . Multi - level degenerative changes of thoracic spine are moderate .
    OUTPUT:
    
Low lung volumes with bilateral moderate pleural effusions and probable relaxation atelectasis . Concurrent pneumonia can not be completely excluded in the appropriate clinical situation .