Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is at the upper limits of normal or slightly enlarged . Within the limits of plain film radiography , no hilar or mediastinal lymphadenopathy is detected . Possible mild background hyperinflation . No CHF , focal infiltrate or effusion is detected . No left - sided pneumothorax is detected . Doubt but can not entirely exclude a tiny right apical pneumothorax . There is a ___ .4 mm diameter rounded opacity superimposed over the upper right heart border -- this is seen only on the frontal view and most likely represents artifact . No free air seen beneath the diaphragms . The visualized portion of the left colon is grossly unremarkable . There is scoliosis , possibly slightly right convex at the level of T4 / 5 and left convex centered at T7 / 8 . Possible rotary component lumbar spine , not fully evaluated . At the periphery of these films , minimal degenerative change in the cervical spine is noted , not fully evaluated .
    OUTPUT:
    
1 . Heart size is borderline . 2 . Possible mild hyper inflation , though the diaphragms are not flattened . 3 . Doubt but can not entirely exclude a right apical pneumothorax . If there is clinical concern for pneumothorax , then an additional frontal view obtained at end - expiration of the respiratory cycle could help for further assessment . 4 . Otherwise , no acute pulmonary process identified . 5 . Scoliosis noted .