Shoulder & Hip Sports MCQs

A 42-year-old recreational tennis player presents with vague, deep shoulder pain. He has a positive O'Brien's active compression test. MRI arthrogram reveals a Type II Superior Labrum Anterior Posterior (SLAP) tear. What is the most evidence-based surgical management for this patient if conservative therapy fails?

A 27-year-old professional volleyball attacker complains of insidious posterior shoulder aching and weakness when attempting to spike the ball. Physical exam reveals notable atrophy of the infraspinatus fossa, but the supraspinatus fossa appears normal. External rotation strength is 3/5, while abduction strength in the scapular plane is 5/5. Where is the most likely anatomic location of nerve compression?

A 25-year-old professional baseball pitcher presents with chronic, posterior shoulder pain during the late cocking and early acceleration phases of throwing. Physical examination reveals a glenohumeral internal rotation deficit (GIRD) of 25 degrees. What is the classic pathophysiologic mechanism of "internal impingement" in this athlete?

A 24-year-old competitive rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals a 24% anterior glenoid bone defect. He has failed an extensive course of non-operative management. What is the most appropriate surgical intervention?

A 28-year-old professional volleyball player complains of vague posterior shoulder pain and selective weakness in external rotation. Exam reveals isolated atrophy of the infraspinatus fossa. MRI is most likely to show a paralabral cyst causing nerve entrapment in which of the following locations?

A 40-year-old male presents to the ED after a seizure. He holds his left arm in internal rotation. Radiographs confirm a posterior shoulder dislocation. CT scan reveals an anteromedial humeral head impaction fracture (reverse Hill-Sachs lesion) involving 30% of the articular surface. Which of the following is the most appropriate surgical intervention?

Glenohumeral Internal Rotation Deficit (GIRD) in the overhead throwing athlete is biomechanically linked to the development of a Type II SLAP tear. Which capsular abnormality is considered the primary driver of this internal rotation deficit and the resultant peel-back mechanism?

During a Latarjet procedure, retractors are often placed deep to the conjoint tendon. To avoid neuropraxia or permanent injury to the musculocutaneous nerve, retractor placement must be carefully monitored. What is the generally accepted 'safe zone' for retractor placement in relation to the coracoid process?

A 28-year-old elite overhead athlete presents with painless weakness in the dominant shoulder. Physical examination reveals isolated severe atrophy of the infraspinatus muscle, but completely preserved muscle bulk and strength of the supraspinatus. Where is the most likely anatomical site of nerve compression?

A 24-year-old male with recurrent anterior shoulder instability is evaluated preoperatively with 3D CT. The concept of the 'glenoid track' is used to evaluate the interplay between glenoid bone loss and a Hill-Sachs lesion. Which of the following correctly defines an 'off-track' Hill-Sachs lesion?

A 40-year-old male presents with a locked posterior shoulder dislocation sustained during a seizure. Imaging reveals a reverse Hill-Sachs (impaction) defect involving 35% of the anterior articular surface of the humeral head. Assuming an intact glenohumeral joint otherwise, which of the following is the most appropriate surgical management?

During a Latarjet procedure for recurrent anterior shoulder instability, careful retraction of the conjoint tendon is essential. Over-retraction medially places which of the following nerves at the greatest risk of iatrogenic injury?

A 28-year-old overhead athlete presents with posterior shoulder pain and weakness in external rotation. Forward elevation and internal rotation strength are normal. MRI reveals a paralabral cyst in the spinoglenoid notch. Which physical examination finding is most likely to be exclusively present?

A 35-year-old male presents with a locked posterior shoulder dislocation following a seizure. CT imaging shows a reverse Hill-Sachs lesion (anteromedial humeral head defect) involving approximately 35% of the articular surface. The joint is unstable after closed reduction. What is the most appropriate surgical management?

A 40-year-old man falls onto an outstretched hand and presents with anterior shoulder pain. He has a positive bear hug test and belly press test. The external rotation lag sign is negative. MRI confirms an isolated tear of the subscapularis tendon. Which of the following associated findings is most likely present?

A 42-year-old male suffers a seizure and subsequently complains of shoulder pain and inability to externally rotate his arm. An axillary lateral radiograph reveals a posterior shoulder dislocation with an anteromedial humeral head defect (reverse Hill-Sachs lesion) involving 35% of the articular surface. What is the most appropriate management?

A 30-year-old elite volleyball player complains of vague posterior shoulder pain and weakness in external rotation. Examination shows isolated atrophy of the infraspinatus fossa. MRI shows a paralabral cyst at the spinoglenoid notch. Which finding is most likely to be present on physical examination?

A 40-year-old male sustains a locked posterior shoulder dislocation during a seizure. A CT scan reveals an anterior articular impaction fracture (reverse Hill-Sachs lesion) involving 30% of the humeral head articular surface. What is the most appropriate surgical management?

A 28-year-old elite volleyball player presents with insidious onset of shoulder pain and isolated weakness in external rotation. An MRI demonstrates a paralabral cyst in the spinoglenoid notch compressing a nerve. This cyst is most commonly associated with which of the following intra-articular pathologies?

When evaluating an MRI of the shoulder for rotator cuff pathology, a hyperintense signal is noted within the substance of the supraspinatus tendon on short TE sequences (T1, PD) that resolves on long TE sequences (T2). The tendon in this region is oriented at approximately 55 degrees relative to the static magnetic field. This phenomenon is best described as: