Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear without consolidation , effusion , or pneumothorax . Left chest wall dual lead pacing device is seen with lead tips in the right atrium and right ventricular apex . Median sternotomy wires and mediastinal clips are again noted . Multiple bilateral rib fractures are noted , most of which appear chronic . There is non visualization of the cortical margin of the right posterior eighth rib fracture which raises possibility of acuity .
    OUTPUT:
    
Multiple rib fractures identified bilaterally with possible acuity of the right posterior eighth rib fracture , to be correlated with patient 's site of pain . Otherwise no acute cardiopulmonary process .