Calcium Barbotage

Painful disorder of the shoulder, which is due to the deposition of calcium hydroxyapatite crystals. Calcific tendinopathy is not always symptomatic.

Indications for Barbotage

Barbotage is usually reserved for patients who suffer acute pain. This results from crystal shedding into the subacromial subdeltoid bursa. Also performed for impingement related to the calcified mass.

Barbotage Procedure

  1. Because barbotage may be painful the patient lies supine and positioned
  2. The operator sits at a comfortable height at the level of the patient's shoulder
  3. Preliminary examination identifies the easiest approach to the calcium
  4. The SASD bursa is infiltrated with local and 40mg methylprednisolone
  5. The calcium conglomerate is punctured as a single pass
  6. Using a 2ml syringe with lidocaine, a pump action is initiated keeping the needle tip in the conglomerate
  7. Aspiration / washout is continued until the aspirated material is clear
  8. Continue until only the eggshell margin of the conglomerate remains
  9. This is then fenestrated

Procedure Videos