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<v ->Thank you very much, Don,

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for inviting me to share the cases with you.

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It's a great honor to be on the program

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with my colleagues from Brazil.

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And I'll try to show the cases here as I read the cases

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and the first one, it's about a patient with shoulder pain,

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male, 38-year old,

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and I'm gonna start showing the T2 fat sat and T1

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from anterior to posterior.

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And how I read this,

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I usually start looking at this subscapularis here,

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long hand of the biceps,

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first, anterior fibers of supraspinatus.

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And we can appreciate

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that he had a lot of bone marrow edema here

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and so intense that this has low signal on T1.

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If you have a low intense signal on T1,

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then it's a big amount of bone marrow edema.

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And we can see some heterogenicity

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at the supraspinatus insertion at the footprint,

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some high signal intensity inside the tendon here in T2.

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The bursa is also filled with fluid.

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We can also see some,

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with more detail, we can also see small dots

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of low signal intensity inside the bursa here,

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and also some low signal

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inside the greater tuberosity of the proximal humerus.

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Let's see another sequence here.

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From superior to inferior we also have some AC joint away.

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We can now, with a better view,

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we can see this edema here

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and this small low signal intensity

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nudging here inside the bone.

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And this is very characteristic

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of a migration of calcification from the tendon to the bone

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and also the migration of a small amount of calcification

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to the bursa, okay?

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And to confirm that, usually we require a x-ray,

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a conventional x-ray.

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And the x-ray can show us and confirm the calcification.

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We cannot see quite well

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the intraosseous migration with the x-ray

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and the MRI is much more sensitive for that.

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So we can confirm that.

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And also we can see that the amount of calcification

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when we look at the x-ray is larger

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than the ones found at the MRI.

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And that's because of the sensitivity of x-ray

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is more sensitive when we look at the

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into tendons calcification

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but not for bone migration.

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So when the calcification migrates into bone or into bursa,

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then the inflammatory process, it really explodes.

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And there are a lot of symptoms with that.