Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest radiograph is obtained . Lung volumes are markedly low limiting evaluation . The upper lungs appear clear . Evaluation for effusion is limited , though no definite effusion is seen . No large pneumothorax . Heart size can not be assessed . Bony structures appear grossly intact .
    OUTPUT:
    
Markedly limited study without definite signs of acute abnormality . Recommend repeat if there are strong clinical concerns .