Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Extensive subcutaneous emphysema has markedly progressed from the prior exam , now involving the entire chest , the neck bilaterally , and left shoulder with re - demonstration of an extensively comminuted left proximal humeral fracture . Left basilar chest tube is new . Assessment for residual pneumothorax is somewhat limited , but likely a small pneumothorax persists . Previously seen mild rightward shift of mediastinal structures is slightly improved . Small pneumomediastinum is also unchanged . There is persistent opacification in the left lung base likely reflecting atelectasis . Right upper lobe peripheral linear and hazy opacity likely reflects a combination of known laceration and adjacent contusion . This is subjacent to a displaced comminuted left lateral 3rd rib fracture . Low lung volumes are present . Marked subcutaneous emphysema somewhat limits assessment of the underlying lung parenchyma . Probable right basilar atelectasis is visualized . Small left pleural effusion persists . No large right pleural effusion or pneumothorax is seen .
    OUTPUT:
    
Left basilar chest tube in place . Assessment for residual pneumothorax is limited , but there is at least likely a small pneumothorax present , with improvement of the previously noted mild rightward shift of mediastinal structures . Small volume pneumomediastinum is also unchanged . Extensive subcutaneous emphysema within the chest and neck has markedly progressed from the prior exam . Persistent left basilar opacification likely reflecting a combination of atelectasis and small pleural effusion . Re - demonstration of the left mid lung field laceration .