Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Slight blunting of the left costophrenic angle may reflect trace left pleural effusion and / or pleural thickening , similar to the prior exam but new since ___ . Otherwise , the lungs are clear . No focal consolidation , edema , or pneumothorax . The heart top - normal in size , unchanged . Left - sided pacemaker defibrillator device is unchanged in position . The mediastinum is not widened . No evidence of acute osseous abnormality .
    OUTPUT:
    
1 . No pneumothorax or acute cardiopulmonary process . 2 . No evidence of fracture ; however , if clinical concern fracture is high , consider dedicated radiographs of the bones targeted to the area of focal findings based on exam O could be performed .