Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperexpanded , with flattening of the hemidiaphragms . There is no focal consolidation . No pleural effusions or pneumothorax are identified . The heart is borderline enlarged . Aortic valve prosthesis is noted . The aorta is markedly tortuous and calcified . A rounded opacity along the right superior mediastinum may represent a prominent vascular shadow versus mediastinal lesion ; recommend comparison to prior imaging , if none , CT . No displaced rib fractures are identified . Note is made of diffuse idiopathic skeletal hyperostosis .
    OUTPUT:
    
1 . Chronic obstructive airways disease . 2 . No displaced fractures . If the patient has focal pain , dedicated rib views can be ordered . 3 . Rounded opacity along the right superior mediastinum may represent a prominent vascular shadow versus mediastinal lesion ; recommend comparison to prior imaging , if none , CT . This finding and recommendation was emailed to the ED QA nurses on ___ at 3 :49 p .m .