Ultrasound-Guided Calcific Barbotage for Rotator Cuff Calcific Tendinopathy: A Case Report

Calcific tendinopathy of the rotator cuff is a common cause of shoulder pain and restricted function, most frequently involving the supraspinatus tendon. While conservative therapy and corticosteroid injections are first-line treatments, some patients experience persistent symptoms. Ultrasound-guided calcific barbotage is a minimally invasive intervention that directly targets calcific deposits. A 68-year-old Asian woman with hypertension and degenerative joint disease presented with a two-month history of left shoulder pain and limited range of motion. Prior corticosteroid injection failed to provide relief. Imaging revealed a calcific deposit in the left supraspinatus tendon. She underwent ultrasound-guided barbotage using an 18G needle for mechanical fragmentation and aspiration.  The procedure was well tolerated without complications. At the five-day follow-up, the patient reported a significant reduction in pain and restoration of full shoulder abduction and overhead motion. Follow-up MRI at two months confirmed maintained rotator cuff integrity and resolution of the calcific deposit. Ultrasound-guided calcific barbotage is an effective, minimally invasive option for patients with rotator cuff calcific tendinopathy refractory to conservative management.