 Good evening everyone. I'm Dr. Fyankar Singh, junior resident in Tirtankar Mahave Medical College in the Sir Center. My topic for paper presentation is role of MRI in non-traumatic shoulder pain. The aim of the study is to demonstrate the role of MRI detecting shoulder pathologies and contraindication of shoulder pain without the history of trauma. The study is conducted in the department of radio diagnosis and this was an observational study of all the patients with the shoulder pain without the history of trauma. Coming to the radio diagnosis department for MRI shoulder was one included in the study population and it was performed using 1.5 tesla senus system using a standard protocol. Introduction non acute shoulder pain is a common medical condition particularly in middle east and older adults. Shoulder pain makes up to 15% of all the musculoskeletal complaints, non acute or chronic shoulder pain is defined as a pain. Lasting at least six months often without a definite inciting traumatic even. There are many causes of non acute shoulder pain and these are listed in order from most to least common include the root retec of impingement, tendinosis, steels, adhesives, capsulitis, subacromy and subdeltoid bursitis, tessific tendinosis, glenuemoral and acroclavicular osteoarthritis, pisoftendinosis, steels. This location internal impingement, rheumatological disorder, tumor, stress fracture and cervical spine disease. MRI has a significant advantage of providing good multi-planar delineation even without the contrast and absence of radiation hazard and detailed information can be obtained regarding the curved effects, including the structure, muscle atrophy and mechanical status of the root retec. The inclusion criteria is the chronic causes of the shoulder pain and the patient of all age group, irrespective of the gender one clorine study and certain criteria for the patient with the history of trauma in the past. Patient having contraindication for MRI like metallic implants, pacemaker, claustrophobic but the contraindication and results and discussion. The distribution of male versus female gender, this pie chart demonstrates the distribution of male versus female gender. My study shows that 67% of male are affected and 33% of females were affected. This is age distribution pie chart. It shows that most of the patients were in the age group 31 to 40 years and then 24% were in the age group 41 to 50 years and 8% were in the age group 51 to 60 years and 21 to 30 years and 12% were in the age group 61 to 70 years. The common pathologies associated with the chronic shoulder pain, the most common were rotator rotator cuff tear, adhesive capsulitis and then adhesive capsulitis and then acromial joint arthritis, infractive etiology, inflammatory arthritis and birthitis. Out of 24 patients, 5 patients were having rotator cuff tear and 5 patients with adhesive capsulitis, 3 patients with ac joint arthritis and tendinosis and infectious tuberculosis respectively. And one patient with inflammatory arthritis and one patient with birthitis. The age distribution in my study was in the range of 22 years to 65 years with the maximum population within 30 to 50 years range. The majority of the cases in the study were male and the most commonly involved side was right shoulder. So out of 24 cases, the majority of cases were include rotator cuff injury and adhesive capsulitis, acromial clavicular arthritis, tendinosis, tubercular etiology, tumor and lastly one case of each inflammatory arthritis and birthitis. Now the rotator cuff tear, the most common non-traumatic causes trauma, we mostly only aggravate the prior inflammatory and degenerative tendon alteration. Supra-spinitor was the most commonly involved for the sub-scapularis infraspinitus, t-dismander and decreasing order. Among these partial tear of rotator cuff were the most common tendon abnormality with the partial tear of supra-spinitor syndrome were the most common. Out of five patient of rotator cuff pathologies in my study, supra-spinitor's tear with the partial tear seen in three patients, complete tear seen in the one patient and infraspinitor's tear was seen in one patient. So the rotator cuff tendinosis or tendinopathy is characterized by thickening without discontinuity of tendon fibres, the presence of increasing signal within the tendon with involvement of supra-spinitor's tendon followed by sub-scapularis tendonosis and infraspinitor's tendonosis. Adhesive capsulitis is a clinical syndrome of pain and severely decreased motion, known as flow in children, caused by the thickening and contraction of joint capsule in sanobyl. Most common finding in our study were abnormal soft tissue thickening within the rotator interval with signal and alteration. Adhesive capsulitis was seen in the patient of middle age group between 30 to 45 years. So the MRI of tubercular etiology, which is characterized by destructed or in sanobyl hypertrophy presence of fluid reservoir as well as extensive restructuring of muscle, stabilizing tendon capsule of the shoulder joint with the immoral bone marrow infiltration enhancement of the hypertrophic synopium and edge enhancement of fluid reservoir were observed after intravenous contrast administration. So these were the cases from my study. These are the cases of rotator cuff tear. In this speedy weighted and detovated image showing hyperintensities are noted within the supra-spinitor's tendons, seen with increased bulk in the tendon near the nearest insertion along with extensive peri tendons fluid and secondary degenerative changes which is appearing hyperintens on both T2 and PD images. So these T2 weighted image also showing the infra-spinitor's tendon along with peri tendons edema, proximal to an insertion and this T1 weighted image showing hyperintensities, this PD weighted image showing hyperintensities along the sub-scapillary tendon at insertion of the immoral head and slightly proximal to it, suggestive of the tendonosis and also the hyperintensities are noted involving the tendon of supra-spinitor's along its posterior aspects at its sites of insertion and adjacent to its along with extending posteriorly towards the tendon of the infra-spinitor's suggesting of tendonosis. And this T1 hypointensities is noted along the long head of biceps tendon and bicepital groove and is inferior to likely reactive fluid. And this T1 weighted image, fat set image showing thickened joint capsule with synovial hypertrophy enhancing areas of marrow edema and enhancing area of erosion and few sub-chondral cysts are also seen. And in this T2 weighted, in this PD weighted image showing hydrogenously hyperintense collection is noted along the middle aspect of the head of humerus which is secondary along with the secondary destructive changes multiple cortical erosion and cortical irregularities with extension and collection of the left glenoid cavity, completely involving the left shoulder joint space with extension into the superior surface capillary cyst and few bony fragments are seen inferior to the immoral head, a suggestive of infective ideology, which is tubercular in nature. This is a case of infective ideology, likely tuberculosis. This is a case of inflammatory arthritis. These are my references. Thank you.