Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated with flattening of the bilateral hemidiaphragms compatible with COPD . No focal airspace opacity , significant pleural effusion or pneumothorax is detected . The pulmonary vasculature is not engorged and there is no overt pulmonary edema . The cardiac silhouette is normal in size . The mediastinal contours and hilar contours are within normal limits . There is tortuosity of the thoracic aorta . An air - fluid level projects in the retrocardiac space compatible with a hiatal hernia . Rib deformities are noted . There is S - shaped thoracic scoliosis .
    OUTPUT:
    
1 . No acute cardiopulmonary process in the setting of COPD . 2 . Hiatal hernia . 3 . Rib deformities and S - shaped thoracic scoliosis .