Shoulder & Hip Sports MCQs

A 22-year-old football player presents with recurrent anterior shoulder instability. A 3D CT scan demonstrates a bipolar bone loss pattern with a Hill-Sachs lesion. Applying the 'glenoid track' concept, an 'off-track' lesion is defined by which of the following criteria?

A 31-year-old volleyball player presents with deep posterior shoulder pain. MRI arthrogram reveals a posterior labral tear with an associated large paralabral cyst extending into the spinoglenoid notch. Clinically, this patient is most likely to exhibit which of the following isolated motor deficits?

A 30-year-old male weightlifter hears a 'pop' and experiences sudden sharp pain in his chest while bench pressing. Examination reveals a loss of the normal anterior axillary fold contour. Intraoperatively, the sternoclavicular head of the pectoralis major is found to be avulsed. What is the normal anatomic insertion of this specific head?

A 40-year-old male experiences a seizure and subsequently presents with a locked posterior shoulder dislocation. Imaging reveals a 30% anterior articular surface defect (reverse Hill-Sachs lesion). Which of the following surgical procedures is most appropriate to prevent recurrent engagement of this specific defect?

A 42-year-old man presents with acute, severe, unrelenting right shoulder pain that began 3 weeks ago without any antecedent trauma. The pain lasted for 10 days and has since significantly improved, but he now notices profound weakness when trying to elevate his arm or externally rotate it. Physical examination reveals prominent atrophy of the supraspinatus and infraspinatus fossae. MRI of the shoulder reveals no rotator cuff tears, but shows diffuse T2 hyperintensity and edema within the supraspinatus and infraspinatus muscles. What is the most likely diagnosis?

A 27-year-old professional volleyball attacker complains of subtle posterior shoulder pain and a subjective decrease in hitting power. Physical exam reveals normal active elevation, 5/5 strength in shoulder abduction, but notable weakness (3/5) in external rotation with the arm at the side. MRI of the shoulder is ordered. Based on the physical exam findings, where is the isolated neural compression most likely located, and what is the classic associated pathologic finding?

A 29-year-old elite volleyball player presents with insidious onset of shoulder weakness. Physical examination reveals isolated atrophy of the infraspinatus fossa with normal bulk of the supraspinatus. Weakness is noted in external rotation. An MRI demonstrates a paralabral cyst. Where is the cyst most likely located, and what is the typical associated labral pathology?

During a Latarjet procedure for recurrent anterior shoulder instability, the coracoid process is transferred to the anterior glenoid neck. Postoperatively, the patient is unable to actively flex his elbow and reports decreased sensation over the lateral forearm. Which of the following surgical steps posed the greatest risk to the injured structure?

A 22-year-old male with recurrent anterior shoulder dislocations undergoes arthroscopic stabilization. Imaging reveals 20% glenoid bone loss and an engaging Hill-Sachs lesion. The surgeon performs a Bankart repair and a Remplissage procedure. Which anatomic structure is tenodesed into the Hill-Sachs defect, and what clinical restriction is most commonly observed postoperatively?

A 28-year-old offensive lineman presents with vague posterior shoulder pain that worsens during blocking maneuvers. The surgeon performs a Kim test to evaluate for a posterior labral tear. Which of the following accurately describes the correct execution of the Kim test?

A professional baseball pitcher presents with vague posterior shoulder pain during the late cocking phase of throwing. Physical examination reveals an internal rotation deficit of 25 degrees compared to the non-dominant shoulder, while external rotation is increased by 10 degrees. Which of the following pathomechanical processes is most directly responsible for this glenohumeral internal rotation deficit (GIRD)?

A 32-year-old elite volleyball player presents with progressive, isolated weakness in external rotation of the shoulder. He denies any acute trauma but reports deep posterior shoulder pain. Clinical examination reveals profound atrophy of the infraspinatus fossa but normal bulk and strength of the supraspinatus. Which of the following intra-articular pathologies is most commonly associated with this specific nerve entrapment syndrome?

A patient presents with poorly localized shoulder pain and paresthesias over the lateral deltoid that worsen when the arm is abducted and externally rotated. An MRI reveals fibrous bands compressing structures within the quadrilateral space. Which of the following correctly defines the anatomic borders of the quadrilateral space?

A 65-year-old sedentary male with a massive, irreparable rotator cuff tear and severe biceps tendinopathy is scheduled for surgery.

The surgeon discusses performing a biceps tenotomy versus a biceps tenodesis. According to highest-level current evidence (systematic reviews and meta-analyses), what is the primary expected difference in clinical outcome between these two procedures in this demographic?

A 21-year-old collegiate javelin thrower presents with chronic posterior shoulder pain.

His pain is highly localized to the late cocking phase of his throwing motion. Arthroscopic evaluation reveals fraying of the posterosuperior labrum and an articular-sided, partial-thickness tear of the posterior supraspinatus and anterior infraspinatus tendons. Which of the following best describes the exact mechanism of 'internal impingement' occurring in this athlete?

A 35-year-old overhead athlete presents with painless weakness in external rotation of the shoulder. Examination reveals atrophy isolated to the infraspinatus fossa. MRI demonstrates a paralabral cyst. At which of the following anatomic locations is the nerve compression most likely occurring?

A 60-year-old male with a massive, irreparable posterosuperior rotator cuff tear and intact subscapularis undergoes a latissimus dorsi tendon transfer. During harvest, the primary neurovascular pedicle must be protected. What is the major arterial supply to the latissimus dorsi muscle?

A 42-year-old man presents with anterior shoulder pain after a fall. On examination, the examiner places the patient's palm on his contralateral shoulder and attempts to lift the hand off the shoulder while the patient resists. Which specific portion of the rotator cuff is best isolated by this test?

A 22-year-old male athlete sustains an anterior shoulder dislocation. An MRI reveals an avulsion of the anterior labrum along with the anterior band of the inferior glenohumeral ligament (IGHL) from the glenoid rim. What is the eponym for this specific lesion?

According to modern quantitative perfusion studies, which vascular structure provides the predominant blood supply to the humeral head, and via which anatomical pathway does it enter?