Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear without consolidation or edema . There is no pleural effusion or pneumothorax . Since the prior exam , lung volumes are lower . The cardiomediastinal silhouette is normal . An old healed right rib fracture is unchanged . Degenerative changes are noted in the bilateral shoulders .
    OUTPUT:
    
No acute cardiopulmonary process .