There is no way for us to know the health of an adult animal from a picture. It looks great, but we'd be able to tell more from the details of its care than a picture. How often was it soaked? What was it fed? Where did it come from? Has it had contact with other tortoises? Have they done a cloacal swab for TINC?
Pyramiding is mostly a cosmetic issue if all other aspects of care have been good. 14 years ago, we were just barely beginning to understand how to raise a smooth tortoise. If that animal was raised here in Southern CA in our dry desert basin climate, then the pyramiding is no surprise.