Ultrasound-Guided Barbotage for Calcific Tendinopathy
A precise, image-guided treatment to break down and aspirate calcium deposits in the shoulder rotator cuff — performed by experienced consultant radiologists at our clinic in Hinchley Wood, serving patients across Esher, Cobham, Oxshott, Surbiton, Hampton, South West London & Surrey.
What is Barbotage?
A specialist intervention for calcific tendinopathy that uses real-time ultrasound to target and treat painful calcium deposits with precision and safety.
How Barbotage Works
Barbotage is a minimally invasive treatment for calcific tendinopathy. Performed under local anaesthetic and guided by live ultrasound imaging, a fine needle is used to break down the calcium deposit and aspirate it — drawing the calcium back into the syringe wherever possible.
A steroid is then injected into the surrounding bursa to reduce pain and inflammation, helping you return to normal activity sooner.
What is Calcific Tendinopathy?
Calcific tendinopathy occurs when calcium crystals accumulate within a tendon, most commonly in the rotator cuff of the shoulder. Although the exact cause is not fully understood, it has been linked to chronic wear and tear.
The deposits can trigger significant inflammation — often involving the subacromial bursa — causing severe shoulder pain that frequently presents acutely.
Identifying & Managing Shoulder Calcific Tendinopathy
Accurate diagnosis through ultrasound imaging followed by a tailored, stepped treatment pathway — from conservative care to image-guided intervention.
First-line, non-invasive options
Image-guided procedural options
How We Diagnose Calcific Tendinopathy
Ultrasound is generally the most informative imaging modality for diagnosing calcific tendinopathy — offering real-time, dynamic assessment of tendon structure and any calcium deposits.
Where the deposits are large enough, they may also be visible on plain X-rays, which can complement the ultrasound findings.
When Barbotage is Not Suitable
We are unable to perform a barbotage procedure for patients on anticoagulant medication. If you take blood-thinning medication, this will need to be discussed with your referring clinician in advance.
Our team will review your full medical history at consultation to confirm suitability and answer any questions.
What to Expect on the Day
A clear, step-by-step overview of your barbotage appointment at our Hinchley Wood clinic.
Welcome & Consultation
You'll meet your consultant radiologist who will review your imaging, explain the procedure, answer questions, and confirm consent.
Ultrasound Assessment
A diagnostic ultrasound scan locates the calcium deposit precisely and confirms the optimal needle approach.
Local Anaesthetic
The skin and underlying tissues are numbed with local anaesthetic to keep you comfortable throughout the procedure.
Barbotage & Aspiration
Under live ultrasound guidance, a fine needle breaks down the calcium deposit, which is aspirated back into the syringe wherever possible.
Steroid Injection
A steroid is injected into the surrounding bursa to reduce post-procedure inflammation and pain.
Aftercare Advice
You'll receive clear written aftercare guidance and advice on returning to physiotherapy and normal activity.
A Safe Procedure with Full Transparency
Barbotage is generally considered very safe. Live ultrasound guidance and aseptic technique with sterile equipment minimise risk throughout. As with any injection, there are some potential side effects to be aware of.
Post-Procedure Care
The local anaesthetic typically lasts 4–6 hours. The treated area may feel uncomfortable or heavy as it wears off — this is normal.
First 48 Hours
Take care of the affected shoulder and avoid using it heavily. Rest, ice and simple analgesia as needed.
7–10 Days
Avoid strenuous activity, heavy lifting and overhead sports. Gentle movement is encouraged where comfortable.
Going Home
We strongly advise arranging a friend or family member to accompany you in clinic or drive you home afterwards.
Trusted Ultrasound-Guided Care Across Surrey & South West London
Our consultant-led clinic at Woodside House, Hinchley Wood, welcomes patients seeking private ultrasound-guided barbotage for shoulder calcific tendinopathy from across the local area — with quick access from Esher, Cobham, Oxshott, Surbiton, Hampton, Weybridge, Kingston and the wider Surrey region.
Your Barbotage Questions, Answered
How much does ultrasound-guided barbotage cost at your Hinchley Wood clinic?
Do I need a referral for barbotage?
How quickly can I get an appointment in Esher, Cobham or Oxshott?
Will barbotage cure my calcific tendinopathy?
Is the procedure painful?
Can I drive home after barbotage?
Can I have barbotage if I take blood thinners?
When can I return to work or sport after barbotage?
Ready to Treat Your Shoulder Pain?
Book a private consultation with our consultant radiology team in Hinchley Wood. Convenient access from Esher, Cobham, Oxshott, Surbiton, Hampton and across Surrey & South West London.