Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear . The heart size is normal . The mediastinal contours are normal . There are no pleural effusions . No pneumothorax is seen . Note is made of a healed right sixth posterior rib fracture . There are multilevel degenerative changes of the thoracolumbar spine as well as moderate thoracic kyphosis .
    OUTPUT:
    
No acute cardiac or pulmonary process .