Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size , mediastinal and hilar contours are normal . An asymmetrical focal opacity is identified at the level of the right first costochondral junction , and is probably related to asymmetrical degenerative changes at this level . Lungs are otherwise clear , and there are no pleural effusions or acute skeletal findings .
    OUTPUT:
    
Focal opacity at level of right costochondral junction , likely due to asymmetrical degenerative changes at this level , but an apical lordotic chest radiograph is recommended to exclude the possibility of a lung nodule , as communicated by phone to Dr . ___ at 7 : 55 a .m . on ___ at the time of discovery .