Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Bronchovascular markings are accentuated by extremely low lung volumes . There is hazy opacification in the left lower hemithorax , which may be due to a small pleural effusion and adjacent atelectasis ; this appears worse when compared to the prior radiograph . The possibility of a small left apical pneumothorax was raised on yesterday 's chest x-ray , but this is not seen on today 's exam . A new oval shaped opacity is seen along the periphery of the left hemithorax , likely representing pleural effusion . Stable cardiomediastinal silhouette . Minimal left cervical and lateral chest wall subcutaneous emphysema , stable in appearance . Thoracic spine fusion device is unchanged in position . Fractures of the left lateral ___ - 7th ribs are likely acute . Right internal jugular introducer and left chest tube are unchanged in position .
    OUTPUT:
    
1 . Worsening left pleural effusion . Oval opacity along the peripheral left upper hemithorax is also likely due to effusion . No pneumothorax . 2 . Fractures of the lateral left ___ - 7th ribs are likely acute .