Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size normal . There is worsening opacity over much of the left lung consistent with pneumonic consolidation . There is a large hiatal hernia . Small left - sided effusion is suggested . No pneumothorax . The visualized osseous structures show a rib fracture of at least the left tenth rib and in probably additional ribs . Remodeling of the left humeral head is partially assessed .
    OUTPUT:
    
Worsening pneumonia and parapneumonic effusion . Left - sided rib fracture