Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear . The cardiomediastinal silhouette is stable . Median sternotomy wires and mediastinal clips are again noted . No acute osseous abnormalities identified . Hypertrophic changes are noted in the spine and there is widening of the right acromioclavicular joint as on prior .
    OUTPUT:
    
No acute cardiopulmonary process .