Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours appear unchanged . The heart is again at the upper limits of normal size . Lung volumes are low . The lungs appear clear . There are no pleural effusions or pneumothorax . Anterior flowing osteophytes are noted along the mid to lower thoracic spine .
    OUTPUT:
    
No evidence of acute disease .