Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Opacity in the left upper lung with adjacent fiducial markers are unchanged . No focal consolidation , edema , or pneumothorax . No large pleural effusion . Cardiomediastinal contours are unchanged . Aortic valve replacement is similar in position and appearance . Incompletely imaged G - tube is noted . The stomach appears distended with gas and fluid contents . Extensive degenerative changes in the shoulders and AC joints are unchanged . Multilevel degenerative changes in the thoracic spine with probable calcification of the anterior longitudinal ligament is again seen . No evidence of an acute osseous abnormality on this nondedicated exam .
    OUTPUT:
    
No acute intrathoracic process on chest radiograph . Please note that this exam is not dedicated for evaluation of rib fractures ; if clinical assessment suggests fracture , dedicated rib films is recommended .