Shoulder & Hip Sports MCQs

A 22-year-old professional baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. Physical examination reveals a loss of internal rotation of 25 degrees compared to the contralateral side. MRI demonstrates articular-sided fraying of the posterior supraspinatus and an intact anterior capsule. What is the primary pathophysiologic mechanism driving this condition?

A 22-year-old collegiate baseball pitcher presents with insidious onset of posterior shoulder pain that is most pronounced during the late cocking phase of throwing. Physical examination reveals a glenohumeral internal rotation deficit (GIRD) of 25 degrees compared to the contralateral shoulder, but symmetric total arc of motion. Which of the following is the primary pathoanatomic alteration driving this clinical presentation?

A 22-year-old elite rugby player undergoes an open Latarjet procedure for recurrent anterior shoulder instability associated with 25% glenoid bone loss.

The primary biomechanical stabilizing effect of this procedure when the arm is placed in the vulnerable position of abduction and external rotation is attributed to:

A 28-year-old male presents after an unprovoked seizure. He complains of right shoulder pain and is unable to externally rotate his arm. Imaging confirms a posterior shoulder dislocation. Further evaluation reveals an impaction fracture of the humeral head known as a reverse Hill-Sachs lesion. Where is this articular defect classically located?

The 'glenoid track' concept is utilized to evaluate bipolar bone loss in anterior shoulder instability. A Hill-Sachs lesion is considered 'off-track' and at risk for engaging the anterior glenoid rim if its medial margin is located where?

A 24-year-old pitcher undergoes arthroscopic repair of a type II SLAP lesion. Postoperatively, he notes significant weakness with external rotation and a vague, aching pain in the posterior shoulder. Physical examination reveals atrophy of the infraspinatus. Which of the following is the most likely cause?

A 55-year-old male is undergoing an arthroscopic rotator cuff repair. A thorough understanding of the anatomic footprint of the rotator cuff is critical for successful anatomic restoration. According to anatomical studies (e.g., Mochizuki et al.), which of the following tendons has the largest insertion footprint on the greater tuberosity?

A 21-year-old collegiate rugby player presents with recurrent anterior shoulder instability. He has had 5 dislocations over the past year. A 3D reconstructed CT scan of the shoulder reveals an inverted-pear glenoid with an estimated 28% anterior inferior bone loss. Which of the following surgical interventions provides the most reliable biomechanical stability and lowest recurrence rate for this specific patient?

A 20-year-old collegiate quarterback sustains a traumatic anterior shoulder dislocation. Post-reduction MRI demonstrates an anterior-inferior labral tear that is displaced medially and rolled down the glenoid neck, still attached to an intact but stripped anterior periosteal sleeve. Which of the following eponymous terms best describes this specific soft-tissue lesion?

During arthroscopic management of anterior shoulder instability, a 'remplissage' procedure is occasionally indicated for a patient with an engaging Hill-Sachs lesion. This technique involves tenodesis of the posterior joint capsule and which of the following structures into the humeral defect?

A 22-year-old male rugby player is evaluated for recurrent anterior shoulder instability. He has had 5 dislocations over the past year. A CT scan of his shoulder indicates 28% anterior glenoid bone loss. What is the most appropriate surgical treatment to minimize his risk of recurrent dislocation?

A 22-year-old football player sustains a recurrent anterior shoulder dislocation. An MRI arthrogram reveals a Bankart tear and a large Hill-Sachs lesion that engages the anterior glenoid rim. What is the best surgical option to address the engaging Hill-Sachs lesion?

Figure 14 shows an intra-articular gadolinium-enhanced MRI scan of a 52-year-old woman who has stopped playing tennis because of pain in her left shoulder while serving. What is the most likely diagnosis?

A 28-year-old professional dancer presents with chronic groin pain, particularly with deep flexion and internal rotation. MRI with arthrogram reveals a large cam lesion with an alpha angle of 80 degrees, a pincer lesion with acetabular retroversion, and a superior labral tear with chondral delamination. Diagnostic injection provides temporary relief.

Given these findings, what is the most appropriate definitive management strategy?

A 70-year-old female presents with chronic pain and weakness in her right shoulder. She has a massive, irreparable rotator cuff tear involving the supraspinatus, infraspinatus, and subscapularis, with significant superior migration of the humeral head and glenohumeral arthritis (Hamada Type IV). Her functional goals include regaining ability to perform activities of daily living.

What is the most appropriate surgical intervention?

A 28-year-old female presents with persistent deep hip pain, particularly with flexion and internal rotation. MRI reveals a cam-type femoroacetabular impingement (FAI) and a labral tear. She has failed conservative management. What is the primary biomechanical goal of surgical intervention for this condition?

A 25-year-old male collegiate baseball pitcher presents with recurrent anterior shoulder dislocations. He has sustained three dislocations in the past year, all related to overhead throwing. Physical examination reveals apprehension with abduction and external rotation. Radiographs, including an axillary view, demonstrate a significant bony Bankart lesion and a Hill-Sachs lesion involving 20% of the humeral head articular surface.

Considering his age, activity level, number of dislocations, and the presence of significant glenoid bone loss, what is the MOST appropriate surgical intervention?

A 60-year-old man undergoes an arthroscopic massive rotator cuff repair. During the procedure, the surgeon releases the coracohumeral ligament to mobilize the retracted supraspinatus tendon. The coracohumeral ligament plays a critical biomechanical role in restricting which of the following shoulder motions?