Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The study is limited due to patient rotation . Moderate cardiomegaly is unchanged . A large hiatal hernia is re - demonstrated . The aortic knob remains calcified . There is no pulmonary edema . Small bilateral pleural effusions , right greater than left are increased compared to the prior study . Bibasilar airspace opacities likely reflect atelectasis , but aspiration or infection is not excluded . There is no pneumothorax . The left humeral head remains chronically dislocated . Diffuse demineralization of the osseous structures is noted with evidence of prior vertebroplasty at the thoracolumbar junction .
    OUTPUT:
    
Small bilateral pleural effusions , right greater than left , slightly increased in size compared to the previous exam . Large hiatal hernia . Bibasilar airspace opacities could reflect atelectasis but aspiration or infection can not be excluded .