Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The previously identified left apical pneumothorax is not clearly identified noting limitation due to patient rotation to the left . Otherwise , there has been no significant interval change . Retrocardiac opacity is again noted . Streaky right basilar opacities persist . Cardiomediastinal silhouette has not changed . Degenerative changes seen at the shoulders .
    OUTPUT:
    
Previously noted left apical pneumothorax is not clearly delineated on the current exam noting suboptimal positioning limiting evaluation .