Calcific Tendinopathy of the Gluteus Medius Mimicking Lumbar Radicular Pain Successfully Treated With Barbotage: A Case Report

Abstract

We report a case of calcific tendinopathy of the gluteus medius initially misdiagnosed as a lumbar herniated intervertebral disc. It was successfully treated with barbotage under ultrasonographic guidance finally. A 56-year-old woman was referred to interventional pain clinic for right hip pain due to an L5-S1 disc herniation. Serial L5 and S1 spinal nerve root blocks and epidural steroid injections were administered. However, pain relief was sustained only for a very short period. Plain radiography of the right hip revealed a solid calcific nodule at adjacent to the insertion site of the gluteus medius tendon. Physical modalities and extracorporeal shock wave therapy failed to improve the pain. Therefore, we attempted ultrasound-guided barbotage of the calcification. Barbotage was performed twice serially and her pain was considerably improved. At 6-month follow-up, the calcification was completely resolved.

Bilateral gluteus medius and minimus calcific tendonitis in a patient with previous bilateral calcific tendonitis of the shoulder: A case report

“…Over-the-counter analgesia, non-steroidal anti-inflammatories, physiotherapy and local steroid injections are established strategies [16] . If symptoms are ongoing and the calcific deposits are large, ultrasound-guided barbotage or arthroscopic removal may be required [ 2 , 17 , 18 ]. In our case, ultrasound-guided barbotage with steroid injection proved therapeutic.…”

Arthroscopic Treatment of Calcific Tendinitis of Gemellus Superior and Gemellus Inferior: A Case Report and Literature Review

“…The frequency: a total of six times, and at an interval of 3-4 days. Jo 22 Gluteus Medius Ultrasonography-guided barbotage One-needle technique.…”

Non-rotator cuff calcific tendinopathy: ultrasonographic diagnosis and treatment

“…Usually occurring in middle-age, patients have functional limitation, tenderness, pain and a positive Patrick's test [183]. Depending on the affected tendon, the differential diagnosis includes infection [124,180], arthritis, lumbar radiculopathy [126,140,168], os acetabuli, avulsion fracture, insertional calcified bursitis, sesamoid bones, myositis ossificans and chondrosarcoma [146]. Sonography and standard radiographs can be used for diagnosis, showing the calcification.…”