Barbotage for Calcific Tendinopathy

What is calcific tendonitis?

Calcific tendonitis is a condition in which the tendons of the shoulder are affected by the deposition of calcium crystals (hydroxyapatite). It is one of the most common shoulder conditions, usually occurring in people aged 40-60, and more frequently in women. It often affects individuals with diabetes or thyroid gland problems.

Calcific tendonitis is divided into two stages:

Calcification stage: In this stage, calcifications are compact and hard, causing mild, chronic pain.
Resorption stage: Calcifications become fluid and have a soft consistency, similar to toothpaste. In this stage, calcific tendonitis is very painful. Common symptoms include difficulty in moving the arm and intense pain that can radiate to the elbow and/or neck.

What is the role of ultrasound in the diagnosis of Calcific Tendonitis?

Although the initial diagnosis of Calcific Tendonitis can be made with a simple shoulder X-ray, ultrasound imaging is the recommended method for visualizing calcifications. It provides detailed information about their size, location, and stage.

When calcifications are in the resorption stage, they can be visualized with ultrasound but may not appear on a standard X-ray. Additionally, ultrasound allows for the study of tendons to determine if there are other issues, such as tendon tears.

What is Barbotage treatment, and what are its advantages?

During Barbotage treatment, under local anesthesia and through a minimally invasive approach, calcifications are flushed with saline, and an anti-inflammatory drug is injected into the subacromial-subdeltoid bursa.

Thanks to ultrasound guidance, Barbotage is an effective and entirely safe procedure. The use of ultrasound ensures both the avoidance of vital structures, such as vessels and nerves, and the targeted injection of the therapeutic substance precisely where it is needed at the site of calcifications.

In contrast to blindly administered injections without ultrasound guidance, Barbotage has higher efficacy as it allows for targeted flushing of calcifications.

What should the patient do after Barbotage treatment?

After Barbotage treatment, patients are advised to take non-steroidal anti-inflammatory drugs orally for a few days and avoid intense physical activity. Physical therapy can begin a week after treatment, enhancing the therapeutic outcome. Barbotage treatment provides immediate pain relief and has very good short-term and long-term results.

Testimonials

An excellent scientist with advanced knowledge, capable of diagnosing damage caused by rheumatic diseases and thus contributing to their effective treatment. I hope there are more scientists like her so that patients can continue to enjoy a good quality of life, as these diseases are incurable.

Alexia S.
I visited Ms. Plagou for a health problem I had with my right Achilles tendon. I congratulate her for her scientific expertise and her unique approach with patients. I thank her very much, and she deserves many congratulations, as do her polite associates.

Nestoras N.
As a surgeon I must simply say, UNBELIEVABLE!! Within 15 minutes I was completely rid of the intense discomfort in my shoulder that had been bothering me for several years. My shoulder feels as it was 10 years ago. Zero pain, incredibly free movement. Congratulations, Mrs. Plagou.

Dr. Dimitrios Alexopoulos
I would like to express my gratitude to Dr. Athena Plagou. With the Barbotage method she applied, she relieved me from terrible pains I had been suffering from for several months due to calcifications in my shoulder.

Before I learned about Dr. Plagou, I had tried cortisone injections, hyaluronic acid injections, and anti-inflammatory medications. Unfortunately, nothing yielded results.

I underwent the Βarbotage procedure in her clinic, very easily and painlessly. When it was over, I had stopped feeling any pain, and it has been three years since then without the slightest discomfort.

Thank you from the bottom of my heart.

Mary P.
State-of-the-art clinic and equipment, exceptional doctor with extensive experience and impressive specialization.

Eirini D.
Ms. Plagou is an excellent scientist with accurate diagnoses, distinguished in her field, and an exceptional person at the same time. She deserves congratulations!

Dr. Chrysovalantou Souhlaki
I had been suffering from Calcific Tendonitis in my left shoulder for over three months, resulting in severe pain. Before I learned about Ms. Plagou, I had tried anti-inflammatory medications, cortisone injections, physiotherapy, all without success, and I was on the verge of serious surgery with doubtful outcomes.

I underwent Barbotage in her clinic very easily, quickly, and painlessly. As soon as the brief procedure was over, my pain ceased, I slept well, and I quickly resumed all my activities.

I want to thank Ms. Plagou both for the impeccable handling of my problem stemming from her excellent scientific training, as well as for her kindness and friendly demeanor.

Zoe K.
I am very grateful to Dr. Athena Plagou. With her high specialization and professionalism, she accurately diagnosed and successfully treated the tendonitis I suffered from in both of my shoulders.

Other specialists I had consulted previously had suggested arthroscopy, which I did not want to undergo due to my age (86) and because the treatment was not guaranteed.

With the special method used by Dr. Plagou, the fluid causing the pain was absorbed, and the pain was immediately relieved without recurrence for the past four months. Besides her high specialization and effectiveness, Dr. Plagou is also very friendly and fully explains to patients the cause of the problem and the treatment process. Her assistant is also very friendly and efficient. Sincere thanks again.

Nikos K.
Her experience, her thoroughness and her love for what she does make her one of a kind. My daughter suffered for months with pain in her wrist. Having visited several orthopedists, having done magnetic resonance imaging and x-rays, only Mrs. Plagou found that she had fluid in her wrist and referred us to a pediatric rheumatologist.

I recommend her. Her assistant is also extremely helpful and kind.

Katerina A.
I want to publicly thank my colleague Athena Plagou for her immediate and effective intervention to treat the problem in my shoulder. The Barbotage method she applied, and in which she is specialized, quickly relieved me from the painful symptoms of Calcific Tendonitis. The return to my daily routine was immediate.

Dr. Vicky Bizimi