Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . The mediastinal and hilar contours are normal . The pulmonary vasculature is normal . No focal consolidation , pleural effusion , or pneumothorax . Widening of the left acromioclavicular joint is difficult to compare because of patient rotation , but it was also present on prior radiograph ___ ___ . Left diaphragmatic contour abnormality posteriorly on the lateral view , has not changed since ___ but is a change from ___ . Old rib fractures bilaterally .
    OUTPUT:
    
1 . Widening of the left acromioclavicular joint has been present since at least ___ . Dedicated AC views may be performed if the patient has pain at this location . 2 . Round contour of posterior left hemidiaphragm is similar to ___ but increased since ___ . This probably represents focal herniated fat from a diaphragmatic defect . However , if clinically warranted , CT chest may be performed to differentiate herniated fat from a localized fibrous lesion of the pleura .