Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest radiographs were obtained . Multiple consecutive rib fractures are again noted on the left . No pneumothorax is appreciated . There is a small left pleural effusion . Lungs are well expanded and clear bilaterally . Cardiomediastinal contours are unchanged .
    OUTPUT:
    
Multiple left rib fractures with a small left pleural effusion and no pneumothorax .