FINDINGS:
The heart is normal in size.  The mediastinal and hilar contours
 appear within normal limits.  There is a coarse interstitial abnormality
 involving the mid-to-lower lungs to a greater degree on the left than right. 
 How much of this appearance may be associated with pre-existing subpleural
 abnormalities that were partly visualized on the prior CT is uncertain since
 no prior radiographs are available for comparison.  Mild-to-moderate relative
 elevation of the right hemidiaphragm compared to the left is similar to the
 prior examination.  There are multiple air-fluid levels, probably in both
 small and large bowel seen in the upper abdomen, but no free air.  Severe
 degenerative change involves the right shoulder including apparent effacement
 of the acromiohumeral interval, spurring along the glenohumeral joint and mild
 acromioclavicular narrowing.

IMPRESSION:
1.  Asymmetric interstitial abnormality involving the left lung.  Correlation
 with the prior CT of the abdomen suggests that much of this appearance is
 potentially chronic, but acute on chronic process such as pneumonia cannot be
 excluded.  Correlation with prior radiographs is recommended if available in
 order to help assess acuity.
 
 2.  Air-fluid levels along small and large bowel, non-specific appearance.
 
 3.  Severe degenerative changes involving the right shoulder.