FINDINGS:
Lung volumes are reduced compared to the previous exam.  The heart size is
 mildly enlarged, but accentuated due to the presence of low lung volumes. 
 Mediastinal and hilar contours are unremarkable.  There is crowding of the
 bronchovascular structures, and possible mild pulmonary vascular congestion
 may be present.  There is no focal consolidation, pleural effusion or
 pneumothorax identified.  Patchy opacities in the lung bases are likely
 reflective of atelectasis.  Diffuse demineralization of the osseous structures
 is again noted.

IMPRESSION:
Low lung volumes.  Probable mild bibasilar atelectasis and possible minimal
 pulmonary vascular congestion.