Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . There is a small to moderate size hiatal hernia . The aorta is tortuous and diffusely calcified . Hilar contours are unremarkable . Lungs are hyperinflated without focal consolidation . Streaky opacities in lung bases likely reflect areas of atelectasis . Pulmonary vasculature is not engorged . There is no pleural effusion or pneumothorax . Moderate multilevel degenerative changes are seen in the thoracic spine . Clips are noted in the upper abdomen on the lateral view . Fractures of the left fourth , fifth , sixth , seventh and eighth posterior rib fractures appear acute . Multiple remote bilateral posterior rib fractures are also present .
    OUTPUT:
    
Several acute appearing left posterior rib fractures involving ribs 4 , 5 , 6 , 7 and 8 . No pneumothorax or pleural effusion . Mild bibasilar atelectasis .