Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral chest radiographs again demonstrate multiple sternotomy wires and a right - sided single lead pacer . The cardiomediastinal silhouette is unchanged . Pleural effusions , if any , are minimal . There is no pleural effusion focal opacity concerning for pneumonia . Also noted is bony destruction at the level of the left shoulder , for which additional views are recommended .
    OUTPUT:
    
1 . No evidence of pneumonia . Pleural effusions , if any , are minimal . 2 . Bony destruction of the level of the left shoulder . Recommend further evaluation with dedicated imaging . These findings were discussed via telephone by Dr . ___ with Dr . ___ at 16 : 54 on ___ .