Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right chest wall Port - A - Cath ends in the right atrium . Cardiomediastinal silhouette is normal . Streaky scarring in the right middle and left upper lobe is again seen . There are extensive expansile lytic rib lesions on the right greater than left consistent with healed rib fractures . Compression deformities of multiple vertebral bodies are grossly unchanged . No definite acute left - sided displaced rib fracture is seen . Diffuse lytic lesions consistent with known multiple myeloma are present .
    OUTPUT:
    
Overall , similar appearance of the chest . No definite acute rib fracture . Given extensive myelomatous involvement , a CT should be considered , if clinically indicated , to better evaluate osseous structures .