Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate enlargement of cardiac silhouette is unchanged . The aorta remains markedly tortuous . The mediastinal and hilar contours are otherwise stable . There is no pulmonary vascular congestion . New focal opacity is seen within the left lower lobe with blunting of the costophrenic recesses posteriorly on the lateral view suggestive of small bilateral pleural effusions . Multiple loose bodies are noted within the right shoulder joint . There are multilevel degenerative changes in the thoracic spine . Numerous osseous metastatic lesions are better seen on the previous CT .
    OUTPUT:
    
Focal opacity within the left lower lobe is concerning for pneumonia , with small bilateral pleural effusions . Known osseous metastatic lesions are better seen on the previous CT .