FINDINGS:
Single portable view of the chest was compared to previous exam
 from .  Tracheostomy tube is again noted.  Diffuse changes in the
 lungs bilaterally consistent with know fibrosis are again noted.  The lung
 bases appear more dense which is likely due to superimposed soft tissues
 without definite acute consolidation.  Cardiac silhouette is enlarged but
 stable in configuration.

IMPRESSION:
No definite acute cardiopulmonary process, findings compatible
 with patient's known underlying interstitial lung disease.  Please note that
 subtle changes from an acute process could be obscured from diffuse
 abnormality.  No large confluent consolidation identified.