Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are again noted to be hyperinflated . No pleural effusion or pneumothorax . Heart size , mediastinal contour , and hila are unremarkable . Limited assessment of the osseous structures are notable for moderate degenerative changes with large anterior osteophytes .
    OUTPUT:
    
1 . Hyperinflated lungs can be seen with emphysema and chronic obstructive airways . 2 . No pneumonia or pleural effusion .