CALCIUM BARBOTAGE
Painful disorder of the shoulder, which is due to the deposition of calcium hydroxyapatite crystals.
Calcific tendinopathy is not always symptomatic
Barbotage is usually reserved for patients who suffer acute pain
This results fromcrystal shedding into the subacromial subdeltoid bursa
Also performed for impingement related to the calcified mass

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