FINDINGS:
Coarse bilateral interstitial opacities are consistent with patient's known
 interstitial lung disease.  There is minimally increased prominence of
 pulmonary vasculature and heart size compared to prior, possibly secondary to
 slightly lower lung volumes and/or interval hydration/fluid overload.  Mild
 congestive heart failure cannot be excluded.  No pleural effusion or
 pneumothorax is seen.  Underlying interstitial lung disease slightly limits
 evaluation for pneumonia, but no new large opacities are detected.  Aortic
 calcification is again seen.  A nasogastric tube traverses below the
 diaphragm, distal tip not well seen.