Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are low inspiratory volumes . Medial uppermost portion both lung apices is obscured by the patient 's chin . Mild prominence the cardiomediastinal silhouette is again noted , similar to prior , but could be accentuated by low lung volumes . Perihilar interstitial markings are slightly increased and there is some atelectasis at both lung bases . Possibility of a possibility of an early infiltrate can not be excluded . No definite upper zone redistribution . No effusion . Superior and inferior vertebral body endplate concavities are seen in 2 lower thoracic vertebral bodies , question T9 and T10 . The configuration is suggestive of sickle cell . Increased density in both humeral heads suggestive of osteonecrosis is noted , question due to osteonecrosis . Tiny ( 4 .5 mm ) density at the left lung apex is again noted , likely a small calcified granuloma . This is unchanged compared with a C - spine CT from ___ .
    OUTPUT:
    
Increased interstitial markings and bibasilar atelectasis , without effusion or definite upper zone redistribution . Question due to CHF , though early pneumonic infiltrates could account for changes at the bases , particularly on the left side . In the appropriate clinical setting , an interstitial infiltrate could have a similar appearance . Suspect mild cardiomegaly , unchanged . Tiny calcified granuloma at the left lung apex .