Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest . VP shunt is again seen overlying the right hemithorax . Left - sided pacemaker with wire is unchanged in position . There is no focal consolidation , pleural effusion or pneumothorax . The cardiomediastinal and hilar contours are normal . There is indistinctness of a posterior lower rib on the right which appears new from prior study , may represent overlapping mildly displaced fracture , less likely a lytic lesion of the bone .
    OUTPUT:
    
No acute cardiopulmonary process . Indistinctness of a posterior lower rib may represent a mildly displaced overlapping fracture or less likely a lytic lesion of the bone . If this is the patient 's area of pain , recommend chest CT for further evaluation . These findings were discussed with Dr . ___ by Dr . ___ at 803 am on ___ by phone .