Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Suspect background hyperinflation . The heart is not enlarged . Aorta is calcified minimally unfolded . There is no CHF , focal infiltrate or consolidation . In particular , no focal opacities suggest aspiration pneumonitis is identified . There are small bilateral effusions , left - greater - than - right , versus small amount of pleural thickening . Focal faint density associated with the right ninth rib could represent sequela from an old healed fracture . Incidental note made of equivocal synostosis of of the fourth and fifth anterior ribs .
    OUTPUT:
    
Small bilateral pleural effusions . No focal opacity to suggest pneumonia or focal aspiration . No pneumothorax detected . Suspect old healed right lower rib fracture , question ninth rib .