Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Subtle left lower lung opacities could represent early pneumonia or atelectasis . There is also bilateral small pleural effusion . Mediastinal and cardiac contours are normal . There is no pneumothorax . Degenerative change of the right shoulder is seen .
    OUTPUT:
    
Subtle left lower lung opacities could be early pneumonia or atelectasis . This was discussed directly with Dr . ___ .