Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral radiographs of the chest demonstrate clear lungs with severe emphysematous changes in the upper lobes , unchanged from the prior examination . The hilar and cardiomediastinal contours are normal . There is no pneumothorax or pleural effusion . Pulmonary vascularity is normal . No displaced fracture is seen .
    OUTPUT:
    
1 . No displaced fracture identified . However this is not a sensitive test for subtle nondisplaced rib fractures . If there is continued clinical concern , a dedicated rib series with a skin marker at the location of the patient 's pain is recommended . 2 . No acute cardiopulmonary process . Emphysema .