Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . There is moderate unfolding of the aorta , which is also tortuous . The right upper mediastinal margin appears convexed and thickened . Otherwise , the lungs appear clear . There are no pleural effusions or pneumothorax . Moderate degenerative changes involve the left shoulder , including narrowing of the acromiohumeral interval and moderate osteoarthritis involving acromioclavicular and glenohumeral joints . Degenerative changes are also suspected on the right side , particularly narrowing of the glenohumeral joint , but the area is not completely imaged .
    OUTPUT:
    
1 . No evidence of acute process . 2 . Widened appearance of the upper mediastinal contour which may in part be due to technique . Particularly since prior radiographs are not available to show stability of this appearance , short - term followup chest radiographs with standard PA and lateral technique are recommended for further evaluation . Findings and recommendations discussed with Dr . ___ at 3 :___ pm on ___ .