Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is bilateral lung hyperinflation with flattening of the diaphragms , unchanged . Lungs are otherwise clear without focal consolidation or pleural effusion . There is unchanged irregularity and elevation of the right diaphragm . The aorta is tortuous . A right shoulder prosthesis is partially imaged .
    OUTPUT:
    
No significant changes since the prior radiograph in ___ . No acute cardiopulmonary process identified .