Ultrasound-guided barbotage
Ultrasound-guided barbotage is a minimally invasive procedure used to treat painful calcium deposits in the shoulder. It can help reduce pain, improve movement and make everyday activities more comfortable. You don't have to manage your symptoms alone. Our experienced specialists at Fortius Clinic will work with you to understand your condition, recommend the most appropriate treatment and support you throughout your recovery, helping you return to the activities that matter most to you. Ultrasound-guided barbotage is performed as a day-case procedure using local anaesthetic, allowing most people to return home the same day.
Specialist expertise
Our consultants use their experience and clinical knowledge to understand your symptoms, confirm the diagnosis and recommend the most appropriate treatment for you.
Sports medicine experience
We regularly support everyone from recreational exercisers to elite athletes, helping people manage injuries and overuse conditions and return to the activities that matter to them.
Flexible access to care
Whether you're self-funding, using private medical insurance or have a referral, we'll help you access specialist care as quickly as possible.
What is ultrasound-guided barbotage?
Ultrasound-guided barbotage is a minimally invasive procedure used to treat calcific tendinopathy, a condition where calcium deposits build up within the rotator cuff tendons of the shoulder. These deposits can cause significant shoulder pain, stiffness and difficulty lifting or moving your arm. During the procedure, your consultant uses ultrasound to locate the calcium deposit before carefully guiding a fine needle into the tendon to break up and remove the calcium. The procedure is carried out using local anaesthetic, so you remain awake throughout and do not usually require a general anaesthetic. Ultrasound also allows your consultant to assess the surrounding structures of your shoulder, helping identify any other conditions that may be contributing to your symptoms, such as bursitis or a rotator cuff tear.
What are the symptoms?
Calcific tendinopathy can cause symptoms including:
- Shoulder pain that may become severe, particularly when lifting your arm
- Pain when reaching overhead or behind your back
- Shoulder stiffness
- Difficulty sleeping because of shoulder pain
- Weakness or reduced shoulder movement
- Pain affecting work, sport or everyday activities
If your symptoms continue despite rest, physiotherapy or other treatments, your consultant may recommend ultrasound-guided barbotage.
How is it diagnosed?
Your consultant will begin by discussing your symptoms, medical history and how your shoulder is affecting your daily life.
To confirm whether ultrasound-guided barbotage is appropriate for you, your assessment may include:
- A detailed medical history
- Examination of your shoulder movement and strength
- Ultrasound scan to identify calcium deposits and assess the rotator cuff tendons
- X-rays to confirm calcific tendinopathy
- MRI scans if further assessment of the shoulder is required
Together, these assessments help your consultant recommend the treatment that's most appropriate for your condition and recovery goals.
How is it treated?
If ultrasound-guided barbotage is suitable for you, your consultant will explain the procedure clearly so you know what to expect before, during and afterwards.
The procedure usually involves:
- Injecting local anaesthetic to numb the area
- Using ultrasound guidance to accurately locate the calcium deposit
- Inserting a fine needle through the skin to break up and remove the calcium
- Gently puncturing the tendon to encourage the natural healing process
- Applying local anaesthetic around the tendon to reduce discomfort following treatment
The procedure usually takes around 20 to 45 minutes and is performed as an outpatient treatment, meaning you can normally return home the same day.
Treatment routes for ultrasound-guided barbotage
Many people with calcific tendinopathy improve without needing a procedure. Your consultant may initially recommend physiotherapy, activity modification, pain relief or, in some cases, an ultrasound-guided injection to help manage symptoms.
If your pain continues despite these treatments, ultrasound-guided barbotage may be recommended.
Recovery goals after ultrasound-guided barbotage
Initially, recovery focuses on:
Managing discomfort around the shoulder Allowing the tendon to begin healing Protecting the treated shoulder as advised Beginning gentle movement when appropriate
As healing progresses, rehabilitation aims to:
Improve shoulder movement Restore strength and function Increase confidence using your shoulder Return to normal daily activities
The final stage of recovery focuses on:
Building strength for work, exercise or sport Improving shoulder control and endurance Returning safely to higher levels of activity where appropriate Reducing the risk of recurring shoulder problems
Ultrasound-guided barbotage FAQs
Calcific tendinopathy is a condition where calcium deposits develop within one of the rotator cuff tendons. These deposits can cause pain, inflammation and restricted shoulder movement.
The procedure is carried out using local anaesthetic to keep you comfortable. You may feel some pressure during treatment, and it's normal to experience mild soreness afterwards for a few days.
Studies suggest ultrasound-guided barbotage improves symptoms in around 70% of patients with calcific tendinopathy. Results vary depending on the size of the calcium deposit, the health of the tendon and individual healing.
You should arrange for someone to take you home after your procedure. Most people can return to driving the following day, provided they can safely control the vehicle without pain or restriction. Always follow your consultant's advice.
Many people benefit from physiotherapy following the procedure. A personalised rehabilitation programme can help restore shoulder movement, rebuild strength and support a safe return to everyday activities.
Working with professionals and teams
Our shoulder specialists support professional athletes, sports teams, active individuals and people whose work places high demands on their shoulders. Working closely with radiologists, physiotherapists and the wider multidisciplinary team, they provide coordinated care from diagnosis through to rehabilitation, helping each person return safely to sport, work or everyday activities.
The same specialist expertise and collaborative approach are available to every patient, whatever your activity level or recovery goals.
Our Experts - Leaders in Shoulder Treatment
Find a clinic near you
Fortius Clinic London
Our 79,000 sq ft, seven-story, private hospital on Wigmore Street has 39 en-suite inpatient rooms, consultation and treatment rooms, and a physiotherapy suite.
The hospital has a high-spec imaging suite fully equipped with an MRI, CT scanner and X-ray machine. There are three state-of-the-art operating theatres, two anaesthetic rooms and a recovery bay.
Fortius Clinic London has two Mako robots for hip and knee joint replacements.
- 66 Wigmore Street W1U 2SB
- 0203 195 2442
- Outpatient times are Monday to Friday from 8.00am to 8.00pm.
- Sports & Exercise Medicine
- Snow Injuries Clinic
- Tendon Clinic
- MRI Scan
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
- CT Scan
- Image guided injections
- Physiotherapy
- MAKO Robotic Joint Replacement
- Knee replacement revision clinic
Fortius Clinic Wimbledon
Our Wimbledon clinic houses a state-of-the-art imaging centre with a 3T MRI and X-ray scanners, Ultrasound, seven consulting rooms, two spacious waiting areas and well equipped treatment rooms all located on one level, ensuring easy accessibility for all patients.
Our partnership with Spire St Anthony’s Hospital allows us to provide orthopaedic surgery closer to our clinic. We treat a full range of conditions and perform joint replacement surgery using the latest Mako robotic assisted technology.
The building at 22 Worple Road has steps leading up to the front entrance. If you require assistance please inform us before your arrival by calling ahead on 020 3195 2442
- 22 Worple Road SW19 4DD
- 0203 195 2442
- Outpatient times are Monday to Friday from 8.00am to 8.00pm.
- Snow Injuries Clinic
- MRI Scan
- Ultrasound
- X-Ray
Fortius Clinic Marylebone
Our Marylebone Clinic is conveniently located in the historic area between Baker Street and Marylebone High Street, just off Manchester Square, home to the iconic Wallace Collection. We have seven consulting rooms, private waiting areas on each floor, well equipped treatment rooms and diagnostic imaging.
- 17 Fitzhardinge StreetW1H 6EQ
- 020 3195 2442
- Outpatient times are Monday to Friday from 8.00am to 8.00pm.
- MRI Scan
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
Fortius Clinic City
Our City Clinic is conveniently located between Bank and Monument stations, within the historic and financial heart of London. At our modern, two-floor facility we have nine consulting rooms, spacious waiting areas, well equipped treatment rooms and an imaging centre.
Explore our City Clinic with our virtual tour.
If you are travelling by Tube, our closest underground stations are Bank and Monument, exit 6 for King William Street.
Should you be travelling by car, the closest parking is a three minute drive away at NCP Car Park London Vintry Thames Exchange. If you are attending clinic on a weekday, please be aware that we are based in the congestion charge zone.
- 75 King William Street EC4N 7BE
- 0203 195 2442
- Outpatient times are Monday to Friday from 8.00am to 8.00pm.
- Snow Injuries Clinic
- Tendon Clinic
- Sports & Exercise Medicine
- MRI Scan
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
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