Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The mediastinal and hilar contours appear within normal limits . Widespread interstitial abnormalities appear unchanged to somewhat improved compared to the prior radiographs particularly in peripheral regions of the upper lungs . The appearance is similar similar to a scout view of the more recent of two prior CT studies , however . There is no pleural effusion or pneumothorax . The lungs are hyperinflated . The bones appear demineralized . Mild degenerative changes are similar along the mid thoracic spine . Cholecystectomy clips project over the right upper quadrant .
    OUTPUT:
    
Chronic - appearing abnormalities which are similar to the scout view from the most recent prior CT and improved since earlier radiographs , although subtle acute on chronic disease is difficult to fully exclude .