Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are relatively hyperinflated . Distortion of the parenchyma suggest chronic underlying fibrotic changes . Cardiomediastinal silhouette is within normal limits . Atherosclerotic calcifications noted at the aortic arch . Chronic changes seen at the right humerus which are not fully assessed . Compression deformity of a lower thoracic vertebral body is not well seen due to osteopenia and is age indeterminate . Bilateral posterior rib fractures appear old .
    OUTPUT:
    
Hyperinflation with distortion of the parenchyma raising the possibility of underlying COPD . No superimposed acute cardiopulmonary process . Compression deformity of a lower thoracic vertebral body , age indeterminate .