Pelvic & Acetabular Trauma MCQs

A 2-year-old boy presents with developmental dysplasia of the hip. A Pemberton osteotomy is planned. What is the primary hinge point for this osteotomy?

A 25-year-old male presents with deep groin pain worsened by hip flexion and internal rotation. Radiographs show a pistol grip deformity. What is the primary mechanism of cartilage damage in this condition?

A 28-year-old male athlete presents with groin pain exacerbated by hip flexion and internal rotation. Radiographs reveal an alpha angle of 70 degrees. Which of the following is the most likely primary mechanism of cartilage damage in this condition?

A 32-year-old female presents with chronic anterior groin pain exacerbated by hip flexion and internal rotation. An anteroposterior (AP) radiograph of the pelvis demonstrates a 'crossover sign.' This radiographic finding is most indicative of which of the following?

A 40-year-old female runner complains of deep gluteal pain radiating down the posterior thigh. MRI reveals narrowing of the space between the lesser trochanter and the ischium, with edema within the intervening muscle. What is the diagnosis?

When stabilizing an acute anteroposterior compression (APC) type pelvic ring injury in a hemodynamically unstable patient, a pelvic binder should be centered over which of the following anatomic landmarks?

A 45-year-old woman with severe developmental dysplasia of the hip (Crowe Type IV) is undergoing total hip arthroplasty. To optimize hip biomechanics and component longevity, where should the acetabular component ideally be placed?

A 22-year-old collegiate hockey player complains of deep anterior groin pain exacerbated by hip flexion and internal rotation. Imaging confirms a prominent alpha angle and an aspherical femoral head. Which of the following best describes the pathophysiology of his condition?

A 24-year-old male arrives in the emergency department following a motorcycle collision. He is hypotensive and tachycardic. Pelvic radiographs demonstrate an anteroposterior compression (APC) type III pelvic ring injury. A pelvic binder is applied. For maximum mechanical effectiveness, the binder must be centered at the level of the:

A 25-year-old male is brought in hemodynamically unstable (BP 85/40 mmHg) after a motorcycle crash, with clinical concern for an open-book pelvic ring injury. A pelvic binder is applied. To be most effective, where must the binder be centered?

Diffuse Idiopathic Skeletal Hyperostosis (DISH) is characterized by flowing ossification along the anterolateral aspect of the spine. According to the Resnick and Niwayama criteria, involvement of how many contiguous vertebral bodies is required to definitively diagnose DISH?

In a patient with a posterior pelvic ring disruption, which ligament is considered the primary and strongest stabilizer against vertical shear forces?

In evaluating a patient with a pelvic ring injury, the presence of an open book pelvis (APC II or III) implies failure of the symphysis pubis and the anterior sacroiliac ligaments. Which pelvic ligament, if intact, prevents pure vertical displacement and distinguishes an APC II from an APC III injury?

In evaluating an acetabular fracture on an anteroposterior pelvic radiograph, the ilioischial line is disrupted. This radiographic landmark represents which anatomic structure of the acetabulum?

A patient with a complex pelvic ring injury presents with profound weakness in hip adduction and an area of decreased sensation over the distal medial thigh. An injury to the obturator nerve is suspected. Which of the following adductor muscles will likely retain partial function due to dual innervation?

A 24-year-old male sustains a vertical shear pelvic fracture following a fall from height. Which ligamentous complex provides the most significant resistance to vertical displacement of the hemipelvis?

During surgical exposure of the posterior pelvic ring, the pudendal nerve must be protected. What is the anatomic path of the pudendal nerve relative to the sacrospinous and sacrotuberous ligaments?

In an anteroposterior compression (APC) pelvic ring injury, progressive disruption of ligaments leads to widening of the symphysis. Which sacroiliac (SI) ligament is the strongest and typically tears last, differentiating an APC-II from an APC-III injury?

A 50-year-old male is brought to the trauma bay after a high-speed motor vehicle collision. He is hypotensive (BP 75/40). Primary survey reveals an unstable pelvis to manual compression. A pelvic binder is ordered. What is the correct anatomic landmark for centering the pelvic binder?

A 40-year-old female arrives after a pedestrian-versus-auto collision. Her blood pressure is 70/40 mmHg. A pelvic binder is applied and the FAST exam is negative. Pelvic radiograph shows an APC-III pelvic ring injury. Despite aggressive fluid resuscitation, she remains hypotensive. What is the most appropriate next step?