FINDINGS:
Lungs are hyperinflated and diaphragms are flattened, consistent with COPD.
 
 There is probable cardiomegaly.  The aorta is calcified and unfolded.
 
 No CHF, focal consolidation, pleural effusion or pneumothorax is detected. 
 Minimal atelectasis and possible minimal blunting of left costophrenic angle.
 
 There is a moderately large hiatal hernia.
 
 Probable diffuse osteopenia.  Note, there is a severe compression fracture
 (near vertebral plana) in the low thoracic spine that results in thoracic
 kyphosis.

IMPRESSION:
1. No evidence of pneumonia.
 2. Background COPD.  Probable cardiomegaly.
 3. Moderately large hiatal hernia.
 4. Severe compression fracture in a low thoracic vertebral body, associated
 with accentuated kyphosis.  This is of uncertain acuity.  If the patient has
 new onset focal symptoms in this area, the possibility of a recent thoracic
 spine fracture would be difficult to exclude and further assessment with MRI
 or CT would be useful.