Shoulder & Hip Sports MCQs

A 28-year-old elite volleyball player complains of vague posterior shoulder pain and isolated weakness in external rotation. Forward elevation and internal rotation strength are normal. MRI reveals a paralabral cyst. Where is this cyst most likely located?

A 22-year-old collegiate baseball pitcher presents with vague shoulder pain and decreased throwing velocity. Physical examination reveals a 25-degree loss of glenohumeral internal rotation compared to the contralateral side, but total arc of motion is symmetric. What is the primary pathophysiologic cause of this internal rotation deficit?

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

A 45-year-old man with a history of seizures presents with a chronic, locked posterior shoulder dislocation. A modified McLaughlin procedure is planned. During this procedure, which anatomic structure is transferred into the reverse Hill-Sachs defect to provide stability?

A 28-year-old elite volleyball player presents with insidious onset of right shoulder weakness. Physical examination reveals normal forward elevation and abduction, but isolated weakness in external rotation. There is prominent atrophy of the infraspinatus fossa, while the supraspinatus fossa is well-preserved. An MRI reveals a paralabral cyst. Where is the cyst most likely located?

A 45-year-old male presents with anterior shoulder pain characterized by a positive 'coracoid impingement test' (pain elicited with the arm in forward flexion, internal rotation, and adduction). Advanced imaging measures the coracohumeral distance to be 4 mm. Pathology involving which of the following structures is most highly associated with subcoracoid impingement?

A 30-year-old rugby player presents with recurrent anterior shoulder dislocations. He has a positive apprehension test and a significant Hill-Sachs lesion on MRI. On physical examination, he demonstrates hyperlaxity. Which surgical procedure is most appropriate to reduce the risk of recurrent dislocation in this patient?

A 32-year-old professional dancer complains of deep groin pain, worse with hip flexion and internal rotation. She also reports clicking and catching sensations. MRI shows a labral tear and pincer-type femoroacetabular impingement (FAI). What is the most appropriate surgical treatment to address both the labral tear and the underlying bony impingement?

A 48-year-old male presents with worsening right shoulder pain and weakness for the past 6 months. He denies trauma. Physical examination reveals a positive impingement sign, painful arc of motion, and weakness with external rotation against resistance. MRI shows a full-thickness rotator cuff tear of the supraspinatus tendon, measuring 1.5 cm. There is no significant fatty infiltration or muscle atrophy. What is the most appropriate management for this active, non-throwing patient?

A 68-year-old male with a history of chronic kidney disease and hypertension presents with shoulder pain and weakness. Imaging reveals extensive calcific deposits within the rotator cuff tendons, particularly the supraspinatus. What is the most likely underlying metabolic etiology?

You are presenting a case of recurrent shoulder instability in a viva. To demonstrate a high level of expertise, you should primarily focus on:

When discussing rotator cuff tears, what is the most important element for an examiner to hear regarding optimal management strategy, beyond just surgical technique?

You are presenting a case of recurrent shoulder instability in an overhead athlete. The examiner asks, 'What specific factors would lead you to favor a bony reconstructive procedure (e.g., Latarjet) over an arthroscopic soft-tissue repair (e.g., Bankart) in this patient?'

You are asked about the differential diagnosis of hip pain in a young adult. After listing common causes, the examiner asks, 'What specific signs or symptoms would raise your suspicion for a rare but critical diagnosis like avascular necrosis (AVN) of the femoral head in this demographic?'

You are asked about the management of a patient with chronic shoulder pain, and you suspect rotator cuff tendinopathy. The examiner asks, 'What is the most important component of conservative management for this condition?'

In a viva, you are asked about the surgical management of rotator cuff tears. The examiner asks, 'What is the primary rationale for repairing a symptomatic, full-thickness rotator cuff tear in an active individual, even if symptoms have been long-standing?'

In assessing the integrity of the AC joint on physical examination, direct palpation over the joint elicits pain. Which other maneuver is particularly helpful in localizing pain to the AC joint?

When performing a clinical examination for AC joint pathology, what is the best way to differentiate pain originating from the AC joint versus the subacromial space?