Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The mediastinal and hilar contours appear within normal limits . There is a coarse interstitial abnormality involving the mid-to - lower lungs to a greater degree on the left than right . How much of this appearance may be associated with pre-existing subpleural abnormalities that were partly visualized on the prior CT is uncertain since no prior radiographs are available for comparison . Mild - to - moderate relative elevation of the right hemidiaphragm compared to the left is similar to the prior examination . There are multiple air - fluid levels , probably in both small and large bowel seen in the upper abdomen , but no free air . Severe degenerative change involves the right shoulder including apparent effacement of the acromiohumeral interval , spurring along the glenohumeral joint and mild acromioclavicular narrowing .
    OUTPUT:
    
1 . Asymmetric interstitial abnormality involving the left lung . Correlation with the prior CT of the abdomen suggests that much of this appearance is potentially chronic , but acute on chronic process such as pneumonia can not be excluded . Correlation with prior radiographs is recommended if available in order to help assess acuity . 2 . Air-fluid levels along small and large bowel , non-specific appearance . 3 . Severe degenerative changes involving the right shoulder .