Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left shoulder replacement is noted . There are low lung volumes with bronchovascular crowding . No focal opacity is seen . There is no pleural effusion or pneumothorax . The cardiomediastinal silhouette is unremarkable . No definite rib fracture is identified .
    OUTPUT:
    
1 . No acute cardiopulmonary process . 2 . No definite rib fractures identified , however chest radiographs are insensitive for nondisplaced rib fractures . If clinical concern persists for fracture , repeated dedicated rib radiographs may be performed with a BB marker placed at the site of the most severe pain .