FINDINGS:
AP and lateral views of the chest.  No prior.  The lungs are
 slightly hyperinflated with flattening of the diaphragms.  There is blunting
 of posterior costophrenic angles compatible with effusions.  There is also
 increased opacity which is pleural-based in the right hemithorax, potentially
 due to pleural thickening or loculated effusion.  Clear delineation of any
 underlying parenchymal abnormalities is limited secondary to this opacity. 
 The left lung is grossly clear.  Cardiac silhouette is within normal limits
 for technique.  Postoperative changes with median sternotomy and mediastinal
 clips are noted.  Dual-lead pacing device is seen with tips in the right
 atrium and right ventricle.  Multiple old bilateral rib fractures are
 identified.  Surgical clips project over the left axilla.  IVC filter seen
 within the mid abdomen.  Compression deformities of the lower thoracic spine
 are noted.

IMPRESSION:
1.  Increased opacity which appears pleural-based in the right suggestive of
 possible effusion which may be loculated or pleural thickening.  This may
 obscure changes in the underlying parenchyma.  Correlation with old films
 would be of use should they become available.
 
 2.  Compression deformity in mid thoracic spine, the acuityl of which is
 uncertain.