Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is again mildly enlarged . The aortic arch is calcified . The mediastinal and hilar contours , including a rounded expansile contour to the right upper mediastinum corresponding to a previously characterized thyroid goiter and tortuous great vessels , appears unchanged . The lungs appear clear . There are no pleural effusions or pneumothorax . Right - sided rib deformities are not well delineated but appear not significantly changed ; these suggest several remote prior fractures .
    OUTPUT:
    
No evidence of acute disease .