Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left lateral approach chest tube remains in place within a loculated left pleural effusion , which is not appreciably changed . The right lung remains clear . There is no pneumothorax . The cardiomediastinal contours are stable . A cortical irregularity with step - off in the lateral rib cage at the level of the chest tube insertion site is due to an acute rib fracture . In addition , the side port of the chest tube is setting in the rib cage , which is suboptimal for drainage purposes .
    OUTPUT:
    
Acute left lateral rib fracture at the chest tube insertion site . Side port of chest tube projects over the rib cage , which is suboptimal for drainage purposes . Unchanged loculated left pleural effusion .