Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Chronic left - sided rib fractures are again noted . The cardiomediastinal and hilar contours are unchanged from ___ . Pleural thickening and blunting at the right costophrenic angle is again demonstrated , and is stable from the prior exam in ___ and likely represents pleural scarring and a small pleural effusion . No focal consolidation or pneumothorax is identified .
    OUTPUT:
    
Multiple chronic appearing left - sided rib fractures . No pneumothorax . Blunting of the costophrenic angle on the right likely represents pleural scarring and a small effusion , not significantly changed from ___ .