Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lung volumes are low with basilar bronchovascular crowding . Compared with ___ , there has been interval development of bibasilar ill - defined opacities . On the lateral view , a spine sign is noted , and there appears to be a tiny right - sided pleural effusion . The left pleural sulcus is clear . The cardiomediastinal and hilar contours are unremarkable . The aorta is tortuous . There is no evidence of pneumothorax . Severe degenerative changes of the right shoulder are noted .
    OUTPUT:
    
1 . Bibasilar opacities suggest pneumonia versus aspiration . 2 . Severe joint disease about the right shoulder .