Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The mediastinal and hilar contours are unremarkable . The pulmonary vascularity is normal . Lungs are clear . No pneumothorax or pleural effusion is present . No displaced rib fractures are visualized . Pseudoarthrosis of the left ___ and 4th ribs anteriorly is noted . There are multilevel degenerative changes in the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary abnormality . No acutely displaced rib fractures identified . If there is continued clinical for a rib fracture , then a dedicated rib series can be obtained .