Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is no displaced rib fracture identified . A small left pleural effusion is not significantly changed compared to the radiographs from ___ . The heart is normal in size . Suture chain is noted along the right paramediastinal region . There are also surgical clips at the right lung apex . The lungs are otherwise clear . Loss of height of mid to lower thoracic vertebral bodies is not significantly changed . Posterior spinal fusion hardware is partially imaged .
    OUTPUT:
    
1 . Unchanged small left pleural . 2 . No displaced rib fracture identified . If there is high clinical concern for a rib fracture , further evaluation be performed with CT .