FINDINGS:
PA and lateral views of the chest.  Bilateral upper lobe scarring is seen with
 superior retraction of the hila.   The lung volumes are relatively low.  There
 is no evidence of superimposed acute process.  Cardiomediastinal silhouette is
 stable.  Surgical clips in the upper abdomen again noted.  Osseous structures
 are essentially unremarkable noting probable right glenoid orthopedic
 hardware.

IMPRESSION:
Bilateral upper lobe scarring unchanged without evidence of superimposed acute
 process.