Shoulder & Hip Sports MCQs

A 25-year-old male sustains an anterior shoulder dislocation during a wrestling match. Following reduction, an MR arthrogram is obtained, revealing extravasation of contrast inferiorly forming a classic 'J' sign. Which structure has been avulsed?

A surgeon is considering a latissimus dorsi tendon transfer for a 55-year-old laborer with a massive rotator cuff tear. Which of the following concurrent physical examination findings is a widely accepted contraindication to this procedure?

The stability of the long head of the biceps tendon (LHBT) as it enters the bicipital groove is maintained by the biceps pulley. Which three anatomical structures form this essential stabilizing sling?

A 55-year-old male with a massive, irreparable posterosuperior rotator cuff tear is scheduled for a latissimus dorsi tendon transfer. Which of the following preoperative clinical findings is considered an absolute contraindication for this procedure?

A 65-year-old woman undergoes anatomical total shoulder arthroplasty for primary osteoarthritis. Six weeks postoperatively, she presents with severe anterior shoulder pain, significantly increased passive external rotation compared to her intraoperative baseline, and a positive belly-press test. What is the most likely complication?

A 22-year-old rugby player has recurrent anterior shoulder instability. A 3D CT scan is used to evaluate the 'glenoid track'. An 'off-track' Hill-Sachs lesion is identified. Which of the following strictly defines an off-track lesion?

A 25-year-old rugby player undergoes a Latarjet procedure for recurrent anterior shoulder instability with 25% glenoid bone loss. During the coracoid transfer, which nerve is at the greatest risk of injury when mobilizing the conjoined tendon?

A 35-year-old male presents with a locked posterior shoulder dislocation after a seizure. CT scan reveals a reverse Hill-Sachs lesion involving 30% of the humeral head articular surface. Which of the following is the most appropriate surgical management?

A 21-year-old collegiate baseball pitcher presents with glenohumeral internal rotation deficit (GIRD) and shoulder pain during the late cocking phase of throwing. What is the primary pathomechanical consequence of an untreated, significantly thickened posterior band of the inferior glenohumeral ligament (IGHL) in this athlete?

A 45-year-old male develops sudden, severe left shoulder pain that lasts for several weeks, followed by profound weakness in shoulder abduction and external rotation. Electromyography (EMG) confirms Parsonage-Turner syndrome (idiopathic brachial neuritis). Which of the following is the most appropriate initial management?

During physical examination of a patient with suspected subscapularis pathology, the examiner performs the 'belly-press test' and the 'lift-off test'. Which specific portion of the subscapularis is maximally tested by the belly-press test?

A 60-year-old male presents with chronic shoulder pain and weakness. MRI shows a massive tear of the supraspinatus and infraspinatus with Grade 4 Goutallier fatty infiltration. Which of the following makes him a poor candidate for a latissimus dorsi tendon transfer?

An 18-year-old male is evaluated for multidirectional instability (MDI) of the shoulder. He has generalized ligamentous laxity and positive sulcus signs bilaterally. Non-operative management with targeted physical therapy has failed after 9 months. If surgery is performed, what is the most critical intraoperative step to ensure success?

A 22-year-old rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 25% anterior glenoid bone loss. The surgeon plans to perform a Latarjet procedure. Which of the following biomechanical mechanisms is considered the primary stabilizer provided by this procedure when the shoulder is in the abducted and externally rotated position?

A 28-year-old male volleyball player presents with insidious onset of vague posterior shoulder pain and isolated weakness in external rotation. An MRI reveals a paralabral cyst extending posteriorly. Compression of the involved neural structure at which of the following anatomic locations is the most likely cause of his specific physical exam findings?

A 23-year-old collegiate hockey player complains of insidious anterior groin pain that worsens with deep flexion. Physical examination reveals limited internal rotation in flexion, and a positive anterior impingement test. Radiographs show an alpha angle of 68 degrees. In Cam-type femoroacetabular impingement (FAI), the offending osseous deformity is most frequently located at which aspect of the proximal femur?

A 25-year-old professional baseball pitcher presents with posterior shoulder pain. Workup reveals 'internal impingement'. This pathologic process involves the articular surface of the rotator cuff becoming pinched between the greater tuberosity and the posterosuperior glenoid. During which specific phase of the throwing motion does this impingement primarily occur?

A 60-year-old male manual laborer presents with chronic shoulder weakness and pseudoparalysis of forward elevation. MRI demonstrates a massive, retracted, and irreparable posterosuperior rotator cuff tear (supraspinatus and infraspinatus) with advanced fatty infiltration (Goutallier stage 4), but the subscapularis is fully intact. There is no evidence of glenohumeral osteoarthritis. Which of the following is the most appropriate tendon transfer to restore active external rotation and elevation?

A 22-year-old rugby player presents with recurrent anterior shoulder dislocations. Preoperative CT imaging reveals 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. Which of the following is the most appropriate surgical treatment?

A 26-year-old hockey player presents with chronic anterior groin pain exacerbated by hip flexion and internal rotation. Radiographs reveal an alpha angle of 70 degrees, a normal center-edge angle (CEA), and a negative cross-over sign. What is the primary pathomechanism of this patient's condition?