Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been no appreciable change in the known moderate right pleural effusion . The right heart border is obscured . The aorta is tortuous . The right upper lung and left lung remain clear . The heart size is unchanged and is within normal limits . No large left pleural effusion is seen . There is no pneumothorax . There is an old healed rib fracture of the posterior right 6th rib .
    OUTPUT:
    
No appreciable change in the moderate right pleural effusion .