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Biomedical subjects

H M Loyd

Publications and source records attributed to H M Loyd.

3 recordsLinked to original sources
PubMed1983

Adhesive capsulitis of the shoulder: arthrographic diagnosis and treatment.

Thirty-one patients (33 shoulders) had clinical adhesive capsulitis confirmed by arthrography and simultaneously treated by intra-articular injection of lidocaine and long-acting corticosteroid introduced with the contrast material during the examination. The routine arthrographic procedure was modified to include gentle passive manipulation of the joint while under the effect of the local anesthetic agent. The patients were instructed to continue exercises at home. The clinical follow-up has averaged eight months. In 31 of the 33 shoulders (94%) excellent relief of symptoms and restoration of function were obtained. There are several advantages to this approach: (1) an accurate diagnosis is made, (2) accurate intra-articular injection of steroid is assured as opposed to blind clinical injections, which often deposit medication in the periarticular soft tissues, (3) the morbidity is much lower than with operative techniques involving general anesthesia, and (4) the therapeutic result has been far better than with the usual program of analgesics and physical therapy.

Adrenal Cortex Hormones↗
PubMed1979

Arthrography in acute shoulder dislocations.

Arthrography of the shoulder was performed on 50 patients with acute traumatic shoulder dislocations. The mean interval between injury and arthrogram was 2.3 days, with a median interval of one day. Anterior dislocations occurred in 96% of patients, and posterior dislocations in 4%. Initial dislocations were present in 74%, and recurrent dislocations in 26%. The most frequent abnormality identified or arthrograms was an enlarged but intact shoulder capsule (58%), most commonly seen in shoulders subject to recurrent dislocations (77%). Shoulder joint capsular tears or disruptions were seen in 48% of the patients. The next most common lesion was fracture (52%), identified on standard roentgenograms. These included Hill-Sachs lesions (28%), greater tuberosity fractures (22%), and coracoid fractures (2%). Ruptures of the rotator cuff, present in 28% of the cases (14 patients), occurred more frequently in initial dislocations (62%) than in recurrent ones (36%). The high frequency of enlarged intact shoulder capsules, even after an acute initial joint dislocation (58%), suggests that the humeral head does not routinely rupture the capsule during dislocation, but rather tears the glenoid labrum at its bony attachment and dislocates subperiosteally, dissecting a false pouch below the periosteum and under the subscapularis.

Acute Disease↗