Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Overall , no significant interval change . Multiple pole focal opacities bilaterally are again seen and not appreciably changed . The lungs are hyperinflated . No pneumothorax or pleural effusion . The heart and mediastinum are normal in size . No pulmonary vascular congestion . Incompletely imaged left shoulder were replacement appears intact . No acute osseous abnormality .
    OUTPUT:
    
No significant interval change in the multiple parenchymal opacities which could be multi focal pneumonia . Again , follow - up radiograph is recommended after treatment in about 4 weeks .