FINDINGS:
There is mild hyperexpansion likely due to underlying obstructive
 lung disease.  Minimal left base atelectasis is evident.  No focal
 consolidation or superimposed edema is noted.  Mediastinum is unremarkable. 
 The cardiac silhouette is within normal limits for size.  No effusion or
 pneumothorax is noted.  Degenerative changes are seen throughout the thoracic
 spine and in bilateral shoulders.  Clips are evident posteriorly in the medial
 left upper quadrant.

IMPRESSION:
Likely underlying obstructive lung disease.  No superimposed
 acute process identified.