Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe dextroscoliosis and low lung volumes somewhat limits assessment . Cardiac and mediastinal contours are unchanged . Pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is present . Extensive degenerative changes are noted in the thoracic spine . Deformity of the sixth posterior right rib is unchanged , and could reflect the sequela of prior fracture .
    OUTPUT:
    
Limited study without gross evidence for pneumonia .