Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared with the prior film , I doubt significant interval change . Again seen is cardiomegaly with a calcified , unfolded aorta ; small left effusion with increased retrocardiac density and obscuration of the left hemidiaphragm , consistent with left lower lobe collapse and / or consolidation ; patchy opacity at the right base with a small right effusio ; and upper zone redistribution , without other evidence of CHF . There is background hyperinflation suggestive of COPD . There is deformity of some of the right upper ribs consistent with old rib fractures . As before , the there is anterior dislocation of the right humeral head with respect to the glenoid .
    OUTPUT:
    
1 . Doubt significant change compared with ___ . No definite acute superimposed process . 2 . Upper zone redistribution , without overt CHF , similar to the prior film . 3 . Small left - greater - than - right effusions , with left lower lobe collapse and / or consolidations and patchy opacity at the right base , unchanged . 4 . COPD and old thoracic deformity again noted . 5 . Anterior dislocation of the right shoulder again noted .