Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Low lung volumes are again noted . There is no consolidation , effusion , or edema . Calcified granulomas noted in the lungs bilaterally . Cardiac silhouette is top - normal . Severe degenerative changes noted at the left shoulder . Hypertrophic changes noted in spine .
    OUTPUT:
    
No acute cardiopulmonary process .