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Image 1 and 2 show the supraspinatus is severely thickened with heterogenous echogenicity, indicating severe tendinopathy. The subacromial subdeltoid (SASD) bursa is mildly thickened.
In image 3, a 25G needle extends from the left of the image with its tip in the SASD bursa which is partly distended from the injectate.
The post-injection video shows the SASD bursa is markedly distended. The small foci of high echogenicity within the superior aspect of the distended bursa are small bubbles of iatrogenic gas.