Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable supine view of the chest . Leftward rotation limits assessment . Lung volumes are markedly low . Kyphotic angulation of the chest with scoliotic deformity also somewhat limits evaluation . Allowing for limitations , the left lung appears clear . There is likely a retrocardiac gas containing structure suggesting hiatal hernia . Right basal opacity may represent a small pleural effusion . No supine evidence for pneumothorax . No definite fracture . Heart size difficult to assess . Mediastinal contour grossly unremarkable though not fully characterized . A compression deformity is noted in the lower thoracic spine , most likely chronic .
    OUTPUT:
    
Limited exam . 1 . Small right pleural effusion . 2 . Probable hiatal hernia . 3 . No overt evidence of pneumonia .