Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again , there is prominence of the hila likely due to central pulmonary vascular engorgement , possibly slightly improved as compared the prior study . There is persistent blunting of the costophrenic angles , left greater than right although no large pleural effusion is seen . The lungs remain hyperinflated . The cardiac and mediastinal silhouettes are stable . No pneumothorax is seen . Multiple old left - sided rib deformities are seen .
    OUTPUT:
    
Central pulmonary vascular engorgement . Multiple old left - sided rib fractures . No definite acute rib fracture seen , although study has limited sensitivity for the detection of such . If high clinical concern for acute rib fracture , dedicated rib series or CT is more sensitive .