Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low , however the lungs are grossly clear . There is a large hiatal hernia . The heart and mediastinum are within normal limits . There is generalized osteopenia and multilevel spinal degenerative changes . Subtle sclerotic lesions in multiple thoracic vertebral bodies likely correspond to known sclerotic metastases . No radiographic evidence of obvious progression or complications . Thoracolumbar spine kyphosis is worsened since ___ .
    OUTPUT:
    
Grossly clear lungs . Large hiatal hernia . Bone metastases .