Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral chest radiograph demonstrates hyperinflated lungs in keeping with COPD . No focal consolidation convincing for pneumonia is seen . Calcified apical pleural thickening and scattered calcified pulmonary nodules are stable and consistent with prior granulomatous infection . Several healed right - sided rib fractures are again identified as seen on prior radiograph dated ___ . There is no pneumothorax or large pleural effusion . When compared to prior radiograph , there has been no change in the cardiomediastinal silhouette . A left pectorally placed pacemaker is identified , its leads in unchanged position .
    OUTPUT:
    
No significant changes . Multiple healed chronic right rib fractures . No acute intrathoracic abnormality .