Shoulder & Hip Sports MCQs

A 22-year-old rugby player has recurrent anterior shoulder instability. CT scan shows a 15% anterior glenoid bone loss and a Hill-Sachs lesion. Applying the glenoid track concept, an off-track lesion is determined. Which of the following best defines an off-track Hill-Sachs lesion?

A 22-year-old hockey player presents with anterior hip pain exacerbated by hip flexion and internal rotation. Radiographs demonstrate a pistol-grip deformity and an alpha angle of 65 degrees. What is the primary mechanism of labral injury in this condition?

During a Latarjet procedure for recurrent anterior shoulder instability, the subscapularis muscle is typically split to expose the anterior glenoid. Which nerve is at greatest risk of injury during the mobilization and transfer of the coracoid process through this split?

A 22-year-old collegiate hockey player presents with groin pain exacerbated by deep flexion and internal rotation. Radiographs demonstrate an alpha angle of 65 degrees. During the pathomechanical process of this specific deformity, where does the maximal shear stress occur?

A 28-year-old elite volleyball attacker complains of insidious onset posterior shoulder pain and isolated external rotation weakness. EMG reveals denervation isolated to the infraspinatus. What pathology is most likely responsible for this presentation?

During a physical examination of a patient with suspected anterior shoulder instability, the examiner applies a posterior-directed force to the humeral head while the arm is abducted to 90 degrees and externally rotated. A sudden release of the posterior force reproduces the patient's apprehension. What is this test called?

A 24-year-old hockey player undergoes hip arthroscopy for symptomatic femoroacetabular impingement (FAI). During osteochondroplasty of the cam lesion at the head-neck junction, the surgeon must be careful to avoid over-resection. Resecting more than what percentage of the femoral neck diameter substantially increases the risk of a post-operative femoral neck fracture?

A 24-year-old professional hockey player presents with deep anterior groin pain exacerbated by hip flexion and internal rotation. An AP pelvis radiograph demonstrates a 'crossover sign', where the anterior wall of the acetabulum crosses lateral to the posterior wall before reaching the lateral edge of the sourcil. This radiographic finding is pathognomonic for which condition?

A 24-year-old professional volleyball player presents with progressive, painless weakness in his dominant shoulder. Physical examination reveals isolated atrophy of the infraspinatus muscle with normal bulk of the supraspinatus. External rotation strength is 3/5. Compression of a nerve is suspected. At what specific anatomic location is the entrapment most likely occurring?

A 60-year-old male has an asymptomatic, full-thickness supraspinatus tear discovered incidentally on an MRI taken for neck pain. What is the most likely natural history of this rotator cuff tear if managed non-operatively?

A 22-year-old elite tennis player presents with posterior shoulder pain during the late cocking phase of serving. Physical examination reveals glenohumeral internal rotation deficit (GIRD). The diagnosis of internal impingement is suspected. Which structures are most likely impinging on one another?

A 55-year-old male slips on ice and falls on an outstretched hand. He presents with pain and weakness during internal rotation. A tear of the upper border of the subscapularis tendon is suspected. Which physical examination test is most sensitive and specific for evaluating an upper subscapularis tear?

A 40-year-old male is brought to the emergency department after a generalized tonic-clonic seizure. His right shoulder is locked in internal rotation and adduction, and he has a mechanical block to external rotation. An AP radiograph shows a 'lightbulb' appearance of the humeral head. Which associated skeletal defect is most commonly present in this specific type of dislocation?

During an open Latarjet procedure for severe anterior shoulder instability with significant glenoid bone loss, the coracoid process is osteotomized and transferred to the anterior glenoid neck. Which specific anatomical structure remains attached to the transferred coracoid process to provide a dynamic 'sling effect'?

A 35-year-old male presents with posterior shoulder pain and paresthesias over the lateral deltoid. MRI reveals severe teres minor atrophy. Compression in the quadrilateral space is suspected. Which of the following boundaries forms the superior border of this anatomical space?

A 22-year-old collegiate baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. Physical examination reveals glenohumeral internal rotation deficit (GIRD). Which of the following pathophysiologic mechanisms best explains 'internal impingement' in this patient?

During a Latarjet procedure for anterior shoulder instability, the coracoid process is osteotomized and transferred to the anterior glenoid. Which nerve is most at risk of injury when mobilizing the conjoint tendon and retracting it medially?

A 28-year-old professional volleyball player presents with isolated weakness in shoulder external rotation. He has no pain or history of acute trauma. Physical examination reveals normal strength in forward elevation and abduction, but profound weakness in external rotation with the arm at the side. Atrophy is noted in the infraspinatus fossa. Where is the most likely location of nerve entrapment?

A 45-year-old male complains of an acute onset of severe, unprovoked right shoulder pain that woke him from sleep. The pain lasted for 2 weeks and was unresponsive to NSAIDs. As the pain finally subsided, he noticed profound weakness in overhead elevation and external rotation. MRI of the shoulder demonstrates diffuse T2 hyperintensity in the supraspinatus and infraspinatus muscles, with structurally intact tendons. What is the most likely diagnosis?

In a patient with a massive, irreparable posterosuperior rotator cuff tear and an intact subscapularis, a lower trapezius tendon transfer is performed. What is the primary functional goal of this specific transfer?