Shoulder Calcific Tendinitis - Aspiration Procedure

 - Patient should be supine to prevent vasovagal syncope. 

 - Arm at side with palm facing up. 

 - Modified Crass can also be used to expose the tendon if not seen clearly, however can be difficult and uncomfortable in Older patients. 

 - Locate the intra-articular portion of the biceps tendon in long axis and shift probe in the same plane posterior and superior until the supraspinatus comes into view in the long axis (see image). 

 - Anesthetize the skin with 1% lidocaine and extend tract down to the calcifications. 

18G hypodermic needle filled with bupivicaine+saline is inserted into the center of the calcification 

 - Short successive pumps Of the plunger (b) to lavage and gentle fenestration should begin to break up the calcification periodically checking syringe for aspirate 

 - The subacromial/subdeltoid bursa is injected of depo-medrol or kenalog, mixed with 2 mL 0.25% bupivicain to prevent bursitis. 



Corbin Pomeranz M.D. https://twitter.com/CorbinPomeranz @JeffersonRads 



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