Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is at the upper limits of normal size . There is a large hiatal hernia . Otherwise , the mediastinal and hilar contours appear within normal limits . The lungs appear clear . There are no pleural effusions or pneumothorax . Mild degenerative changes are noted along the lower thoracic spine with narrowing of a thoracolumbar interspace , probably T12 - L1 . There are age - indeterminant non-displaced right - sided fourth and fifth rib fractures .
    OUTPUT:
    
1 . Large hiatal hernia . 2 . No evidence of acute cardiopulmonary disease . 3 . Non-displaced right - sided rib fractures . There is an irregularity along the left anterior fifth rib seen on two dedicated right rib views , fracture that is age - indeterminate but not displaced .