Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable supine view of the chest . Dual lead pacer is noted with pacer pack projecting over the left chest wall and leads extending to the region of the right atrium and right ventricle . Predominately left - sided calcified pleural plaque is noted likely accounting for the opacity projecting over the lateral aspect of the left lower lung . Evaluation for a subtle pneumonia in this area is therefore limited . Otherwise , no signs of pneumonia . No supine evidence for effusion or pneumothorax . Cardiomediastinal silhouette appears normal . Chronic right rib deformities are noted involving the fourth , fifth , sixth , seventh , eighth , and ninth ribs .
    OUTPUT:
    
Chronic right rib cage deformities . Calcified pleural plaque . Pacemaker in appropriate position . If there is strong clinical concern for an acute fracture , recommend dedicated rib series with a BB marking the site of maximal pain .