FINDINGS:
Assessment is slightly limited by patient rotation and kyphotic positioning. 
 Cardiac silhouette size remains moderately enlarged.  A large hiatal hernia is
 again noted.  The aortic knob is calcified.  The mediastinal and hilar
 contours are grossly unchanged.  There are low lung volumes with crowding of
 bronchovascular structures and pulmonary vascular congestion, but no overt
 pulmonary edema.  No large pleural effusion or pneumothorax is identified,
 though assessment of the lung apices is limited due to the patient's chin and
 neck projecting over these areas.  Linear atelectasis is noted in the left
 lung base.  There is no focal consolidation.  The osseous structures are
 diffusely demineralized.

IMPRESSION:
Limited exam.  Mild pulmonary vascular congestion and left basilar
 atelectasis.  Large hiatal hernia.