Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A right total shoulder prosthesis is noted . A rounded calcific density measuring approximately 5 mm overlying the left sternoclavicular joint is consistent with a granuloma . There is no focal consolidation , pneumothorax , or pulmonary edema . The cardiomediastinal silhouette is within normal limits . Slight density posterior to the right hemidiaphragm may represent mild pleural thickening or a tiny right effusion .
    OUTPUT:
    
Possible tiny left pleural effusion .