Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Slightly rotated positioning . Portable semi-upright radiograph of the chest demonstrates slightly low lung volumes . The cardiomediastinal silhouette and pulmonary vasculature are unchanged since the prior examination , with mild to moderate cardiomegaly and slight unfolding of the aorta again noted . Increased right paramediastinal density immediately below the right clavicular head likely represents artifact due to patient obliquity . No CHF . There is no definite pleural effusion or pneumothorax . Equivocal tiny right sided effusion . No obvious focal infiltrate and no focal consolidation is identified .
    OUTPUT:
    
No pneumonia . Doubt but can not entirely exclude a tiny right effusion . Probable artifact in the right paramediastinal region due to patient obliquity . If clinically indicated , PA and lateral views of the chest could help for further assessment .