What is calcific tendonitis?

This is a condition whereby a lump of calcium develops within the inner tendons of the shoulder. It can cause a range of symptoms from sudden extreme pain to intermittent low grade pain in certain positions. The reason why bone is formed in the tendon is not completely understood, but it is probably as a result of irritation of the tendons. It can be diagnosed using X ray or ultrasound.

How is calcific tendonitis treated - What is Barbotage?

Barbotage is a procedure to try and breakdown the solid lumps of calcium using a needle. When calcium is semisolid, water pressure through syringe can be used in certain cases to washout the calcium substance out.

Calcification may be found in patients with no symptoms whatsoever. In such cases not specific treatment is required. Sometimes it is not clear if the calcification causes any pain or not; in such cases steroid injection is useful to find out how much pain comes from the calcification and if further treatment (Barbotage) is required.

What will happen during my Barbotage appointment?

Allow 10-15 min before your appointment time.

There is no preparation required for the scan.

You may be asked to change into a gown.

The procedure takes 20-30min and will be performed by a specialist musculoskeletal radiology consultant.

You will be in sitting or reclined position during the procedure.

The radiologist will do the ultrasound scan first to assess the calcium deposit and discuss with you the procedure in details.

The skin and the tendon is numbed first with an injection.

While watching continuously the needle will be guided into the calcium lump. Punctures will be performed targeting all sections of the lump. The needle is guided precisely and watched at all times and thus risk of tendon injury is kept to minimum.

If the calcium lump is semisolid using another needle the deposit is washed out removing calcium debris and suspension.

After the procedure a steroid injection is given through the same needle and the area will be covered with a small dressing.

You will be asked to stay in the department afterwards for 15-30 min or so to make sure that you are comfortable before you set off.