Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and images of the chest demonstrate well - expanded lungs which are clear . There is no pneumothorax or pleural effusion . There are old compression fractures of two vertebral bodies noted in the spine . There is significant degenerative joint disease of the shoulders . There is mild cardiomegaly . There is no evidence of acute cardiac or pulmonary process on this exam .
    OUTPUT:
    
No evidence of acute cardiac or pulmonary process on this exam . Essentially unchanged chest radiograph .