Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardio mediastinal contours are normal and unchanged . Left chest tube is in place . Mild increase in subcutaneous air extending to the contralateral side in the neck as well as pneumomediastinum . Difficult to assess for presence of pneumothorax given superimposed subcutaneous air . Right lung is clear . Small left pleural effusion unchanged compared to chest radiograph performed earlier on the same day .
    OUTPUT:
    
Mild increase in subcutaneous emphysema to the contralateral side in the neck as well as pneumomediastinum . Left chest tube is in place . Difficult to assess presence of a pneumothorax , chest CT would be the best next imaging modality for further evaluation .