FINDINGS:
Lungs are well expanded multifocal opacities in the lower lobes and in the
 lingula largest in the lingular consistent with multifocal pneumonia.  . 
 Mediastinum and hila are normal.  The heart is mildly enlarged in the left
 heart border is obscured.  A left anterior fourth rib expansile deformity may
 represent an old fracture although is not seen on prior examinations.

IMPRESSION:
1. Multifocal pneumonia.
 2. Left fourth anterior rib deformity may represent a chronic fracture
 although CT chest is recommended to exclude osseous malignancy.
 
 RECOMMENDATION(S):  Noncontrast CT of the chest is recommended for further
 evaluation.