FINDINGS:
There is persistent opacification projecting in the lateral aspect of the
 right upper lobe demonstrated along the fissure on the lateral view that is
 mildly improved since .  There is associated overlying pleural
 abnormality relating to healing rib fractures.  There are no new areas of
 focal opacification.  There are no pleural effusions or pneumothorax.  The
 cardiomediastinal and hilar contours are stable demonstrating moderate
 cardiomegaly and tortuosity of thoracic aorta.  A large hiatal hernia is
 unchanged.  Pulmonary vascularity is not increased.
 
 There are extensive rib fractures of varying ages.  In addition there is lytic
 destruction of several right-sided lower thoracic ribs.  There is an old left
 clavicular fracture.  There are multiple wedge compression deformities of the
 thoracolumbar spine grossly stable since .

IMPRESSION:
1.  Persistent right upper lobe opacification has only mildly improved since
 .
 2.  Multiple rib fractures of varying age and an old left clavicular fracture
 with lytic destruction of the several right lower thoracic ribs more apparent
 since .