Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated with emphysematous changes again noted , most pronounced in the upper lobes . Infrahilar clips on the right are re - demonstrated . Heart size is normal . Mediastinal and hilar contours are unchanged . Pulmonary vasculature is not engorged . Linear atelectasis is seen within the left lower lobe . No focal consolidation , pleural effusion or pneumothorax is present . No acute osseous abnormality is identified . Remote fracture of the right fifth posterior rib is again noted .
    OUTPUT:
    
Emphysema . No acute cardiopulmonary abnormality .