Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette is mildly enlarged , unchanged from prior . Mediastinal silhouette and hilar contours are unremarkable . Lungs are clear . Pleural surfaces are clear without effusion or pneumothorax . There is severe degenerative change in the bilateral shoulders .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Severe bilateral shoulder degenerative changes .