FINDINGS:
AP and lateral views of the chest are compared to previous exam
 from .  Right chest wall dual-lead pacing device again seen
 with lead tips in the right atrium and right ventricular apex.  Nodular
 density in the right upper lung just medial to the pacing device is stable
 dating back to .  Probable calcified right hilar lymph node. 
 The lungs are otherwise clear of consolidation or effusion.  Cardiac
 silhouette is slightly enlarged but unchanged.  Severe left glenohumeral joint
 degenerative changes are noted.

IMPRESSION:
No acute cardiopulmonary process.