Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is again seen evidence of prior right humeral fracture . There is unchanged degenerative joint disease of the thoracic spine as compared to radiograph obtained ___ . The cardiomediastinal silhouettes are normal and unchanged in appearance . The bilateral hila are normal . There are no focal lung consolidations . There is no pulmonary vascular congestion . There is a new small left - sided pleural effusion . There is no right effusion . There is no pneumothorax .
    OUTPUT:
    
New small left pleural effusion . No evidence of pulmonary vascular congestion or pulmonary edema .