Best Practice Case Studies-Calcific Tendonitis RC

Video Transcription

Hi, this is Sagar Wagle, one of the musculoskeletal radiology fellows at Stanford University.  We have a case of a 56 year old female with acute unsaid shoulder pain and palpable mass.  Radiographs show a calcification  overlying the lesser tuberosity of the humeral head corresponding to the palpable mass.  This calcification appears as a low signal intensity on MRI, and this is hyperechoic on  ultrasound. This is consistent with calcific tendinopathy of rotator cuff tendon. This is treated by Barbatas. In Barbatas, a needle is punctured into the calcification, a  solution containing serine and lidocaine is squirted in. Because there is not much space for the lidocaine to go out, the lidocaine and serine goes back in and takes  calcification with it. Here's a video.  So this is done with ultrasound guidance, and  here we can see the solution being injected in and it squirts and goes back into the needle.  And this is the calcification that came out. I have another case of a 43 year old female with shoulder pain. On the x-ray, we see this amorphous calcification  overlying the humeral head in the position of rotator cuff tendon. The calcification appears as low signal intensity  speculations on MR. Here is coronal MR showing the low signal intensity speculation, and this is the calcification and this was treated with Barbatas again.  Thank you for watching the video.

Video Summary

In the video, Sagar Wagle, a musculoskeletal radiology fellow at Stanford, discusses cases of calcific tendinopathy in the shoulder. A 56-year-old woman with a palpable mass and shoulder pain exhibits calcification on the humeral head, visible through various imaging techniques. This condition is treated using the Barbatas procedure, where a needle injects a serine and lidocaine solution into the calcification, which is then washed out along with the calcified material. Another case involves a 43-year-old woman with similar symptoms, treated using the same method. The procedure is guided by ultrasound.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 51

Topic Shoulder

Keywords

3rd Edition, CASE 51

3rd Edition

Shoulder

calcific tendinopathy

Barbatas procedure

shoulder pain

ultrasound guidance

musculoskeletal radiology