Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest were provided . The lungs are hyperinflated . Cervical fixation hardware is noted in the lower neck . Old right mid rib cage deformity is again noted . There is no focal consolidation , effusion or pneumothorax . Cardiomediastinal silhouette is normal . Bony structures appear intact . There is no acute fracture identified .
    OUTPUT:
    
No signs of pneumonia . COPD / emphysema noted .