Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . The aortic knob is densely calcified . Mediastinal and hilar contours are unchanged . Pulmonary vasculature is not engorged . Lungs are hyperinflated with marked emphysematous changes again noted . A fiducial marker in the right upper lobe of the lung is in unchanged position . 10 mm nodule within the right juxta hilar region is unchanged . No focal consolidation , pleural effusion or pneumothorax is identified . There are no acute osseous abnormalities . Marked narrowing of the right acromial humeral interval with sclerosis of the acromion and superior humeral head as well as superior subluxation of the humeral head relative to the glenoid is compatible with rotator cuff disease . Moderate degenerative changes the right glenohumeral joint are also noted .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Unchanged right juxtahilar nodule and fiducial marker in the right upper lobe . Emphysema .