Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: No new relevant findings in the chest . Multiple , bilateral rib fractures leading to deformity of the thoracic cage is similar . No lung opacities concerning for infection . Mild elevation of the left hemidiaphragm is unchanged . Cardiomediastinal silhouette is normal . Status post total left shoulder arthroplasty .
    OUTPUT:
    
No acute cardiopulmonary process .