Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient has had previous spinal fixation and interval right shoulder replacement . Previous left shoulder replacement is again noted . Increased perihilar airspace opacities with increased artery bronchial ratios suggest fluid overload . The small left pleural effusion is not appreciably changed . Mild cardiomegaly despite the projection is unchanged . There is no pneumothorax .
    OUTPUT:
    
Increased bilateral airspace opacities are most likely due to worsening pulmonary edema . The differential diagnosis includes transfusion related lung injury . Stable small left pleural effusion .