Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Multiple left sided posterior rib fractures are again seen . There is a tiny left apical pneumothorax . The lungs are clear of focal consolidation or pleural effusion . The heart and mediastinal silhouette is normal .
    OUTPUT:
    
Multiple posterior left - sided rib fractures . Tiny left apical pneumothorax .