Shoulder & Hip Sports MCQs

A 42-year-old male presents with severe, unprovoked left shoulder pain that awoke him from sleep. The pain lasted intensely for two weeks and then gradually subsided, but was subsequently replaced by profound weakness in shoulder abduction and external rotation. MRI of the shoulder and cervical spine are unremarkable. Electromyography reveals active denervation in the supraspinatus, infraspinatus, and deltoid. What is the most likely diagnosis?

An elite collegiate baseball pitcher is diagnosed with Glenohumeral Internal Rotation Deficit (GIRD) after presenting with a significant loss of internal rotation and a total arc of motion that is 20 degrees less than his non-throwing shoulder. Which of the following pathologic changes is the primary driver of this symptomatic internal rotation loss?

In a patient undergoing a Latarjet procedure for recurrent anterior shoulder instability with 30% glenoid bone loss, what is the primary mechanism by which this procedure confers anterior stability?

A 24-year-old hockey player presents with groin pain exacerbated by hip flexion and internal rotation. Radiographs reveal a cam-type femoroacetabular impingement (FAI). Which of the following anatomic abnormalities is the primary driver of this specific type of impingement?

In the decision-making process for anterior shoulder instability surgery, glenoid bone loss is a critical factor. At what approximate threshold of anterior glenoid bone loss is an isolated arthroscopic Bankart repair generally considered to have an unacceptably high failure rate, thereby mandating a bony augmentation procedure (e.g., Latarjet)?

A 42-year-old male presents with sudden onset of severe, unrelenting right shoulder pain lasting for two weeks, which has now begun to resolve. However, he now notices profound weakness in active external rotation and abduction. Examination demonstrates noticeable atrophy of the supraspinatus and infraspinatus. An MRI of the shoulder is negative for a rotator cuff tear. EMG reveals acute denervation potentials in the affected muscles. What is the most likely diagnosis?

A 65-year-old female has a massive, irreparable posterosuperior rotator cuff tear and poor forward elevation. A latissimus dorsi tendon transfer is proposed. Which of the following physical examination findings is considered a strong contraindication or predictor of poor outcome for an isolated latissimus dorsi transfer?

A 22-year-old overhead athlete presents with recurrent anterior shoulder instability. Magnetic resonance arthrography demonstrates that the anterior labroligamentous complex is avulsed from the glenoid rim and displaced medially and inferiorly along the glenoid neck. The anterior scapular periosteum remains intact but is stripped from the bone. Which of the following eponymous lesions is described?

A 32-year-old elite volleyball player presents with insidious onset of vague posterolateral shoulder pain. Physical examination reveals isolated atrophy and weakness of the infraspinatus muscle. Supraspinatus strength and bulk are completely normal. MRI is expected to reveal a paralabral cyst causing nerve compression at which anatomical location?

A 28-year-old professional volleyball player presents with insidious onset of vague posterior shoulder pain and weakness in external rotation. Examination reveals isolated atrophy of the infraspinatus with normal supraspinatus bulk and strength. Where is the most likely anatomic location of the nerve compression?

A 22-year-old rugby player has recurrent anterior shoulder instability. A 3D CT scan is obtained to calculate the 'glenoid track'. If the patient's Hill-Sachs interval (HSI) is determined to be greater than the calculated glenoid track, what is the most appropriate management alongside an anterior stabilization procedure?

A 22-year-old contact athlete undergoes a Latarjet procedure for recurrent anterior shoulder instability associated with 25% glenoid bone loss. The 'sling effect' of this procedure, which contributes significantly to stability at end-range abduction and external rotation, is primarily mediated by which of the following structures?

A 65-year-old female sustains a 3-part proximal humerus fracture involving the surgical neck and the greater tuberosity. The greater tuberosity fragment is characteristically displaced by the primary deforming forces of the attached musculature. In which direction is this fragment typically displaced, and by which muscles?

A 55-year-old manual laborer with an irreparable, massive posterosuperior rotator cuff tear and intact cartilage undergoes a Superior Capsular Reconstruction (SCR) using a thick dermal allograft. The primary biomechanical goal of the dermal allograft in this procedure is to:

A 22-year-old rugby player presents with recurrent anterior shoulder instability. CT evaluation reveals 25% anterior glenoid bone loss. Which of the following procedures is most appropriate to restore stability?

A 40-year-old female recreational basketball player notes pain deep within her shoulder that occurs with activity. Pain began insidiously 6 months previously. She has completed a physical therapy program, and an intra-articular corticosteroid injection provided excellent temporary relief. Physical examination shows symmetric range of motion of her shoulder. She has a positive O'Brien’s active compression test. There is no pain with cross-arm adduction or tenderness to palpation over the acromioclavicular joint. Resisted abduction is nonpainful and strong. MRI shows increased signal in the substance of the superior labrum, low-grade bursal surface fraying of the supraspinatus, and mild degenerative changes within the acromioclavicular joint. What is the best treatment option?

A baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. He is diagnosed with internal impingement. Which of the following is the hallmark pathological finding?

A 35-year-old male presents with isolated weakness in external rotation of his dominant shoulder. MRI reveals a paralabral cyst in the spinoglenoid notch. Which of the following physical examination findings is most likely?

In a Latarjet procedure for recurrent anterior shoulder instability, the crucial 'sling effect' that dynamically stabilizes the anterior shoulder is primarily provided by: