Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided central venous catheter tip is seen in the upper right atrium . The lungs are clear of focal consolidation or effusion . Cardiac silhouette is slightly enlarged , even given differences in technique compared to prior , enlarged since ___ . No acute osseous abnormalities identified . Degenerative changes are noted at the shoulders bilaterally .
    OUTPUT:
    
Cardiomegaly without acute cardiopulmonary process .