Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Mild enlargement of the cardiac silhouette is stable . The thoracic aorta appears to be tortuous , but cardiomediastinal contours are otherwise unremarkable . The lung volumes are reduced , and there is increased AP diameter of the chest secondary to known severe kyphosis of the thoracic spine with evidence of old compression fractures at multiple levels . There is also evidence of old rib fractures on the left . Lungs are clear . No pleural effusions and no pneumothorax .
    OUTPUT:
    
No significant changes compared to the prior study .