Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The opacity previously seen in the right right mid / upper zone is larger and less distinct , suggesting progression . There is more pronounced patchy opacity at the left base . There is also a new small left pleural effusion . Previously seen right infrahilar patchy opacities obscured by surrounding vascular plethora . There is increased vascular plethora , consistent with mild CHF . Heart size is at the upper limits of normal or slightly increased . Note is again made of a partially imaged left total shoulder prosthesis . Slight flattening of the right humeral head is included in suggest the presence of osteonecrosis or impaction injury involving the right humeral head .
    OUTPUT:
    
Mild vascular plethora , increased compared with ___ , consistent with CHF . Larger right mid / upper opacity and increased in left infrahilar opacity concerning for pneumonic infiltrates . These must be followed to resolution to exclude underlying chronic abnormalities . New small left effusion with underlying atelectasis . Suspect osteonecrosis with subtle articular surface collapse of the right humeral head . There clinically indicated , MRI could help to confirm this .