Shoulder & Hip Sports MCQs

A 21-year-old collegiate rugby player with a history of recurrent anterior shoulder dislocations presents for surgical evaluation. A 3D CT scan demonstrates a 27% anterior glenoid bone loss and an engaging Hill-Sachs lesion. Which of the following is the most appropriate surgical management?

A 45-year-old recreational tennis player has symptomatic failure of nonoperative management for an isolated Type II SLAP tear. In this specific demographic, which surgical intervention has been shown to yield the highest patient satisfaction and return to sport rates?

Internal impingement of the shoulder in an elite overhead thrower typically involves the compression of which of the following structures during the late cocking/early acceleration phase?

A 21-year-old baseball pitcher presents with deep shoulder pain during the late cocking phase of throwing. MRI arthrogram reveals a Type II SLAP tear. After 3 months of physical therapy focusing on periscapular stabilization and posterior capsular stretching, his symptoms persist. What is the most appropriate surgical intervention?

A 22-year-old baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. On examination, he has pain with abduction and external rotation, which is relieved by a relocation maneuver. What is the most likely underlying arthroscopic finding?

A 28-year-old professional volleyball player presents with insidious onset of posterior shoulder pain and weakness. Examination reveals isolated weakness in external rotation with the arm at the side. MRI demonstrates a paralabral cyst at the spinoglenoid notch. Which muscle is most likely to show denervation changes on EMG?

A 68-year-old man underwent an anatomic total shoulder arthroplasty via a deltopectoral approach 6 weeks ago. He now complains of new-onset weakness and a sensation of anterior instability. On examination, he has increased passive external rotation compared to the contralateral side and a positive belly-press test. Failure of which of the following structures is most likely responsible?

A 21-year-old male contact athlete presents with recurrent anterior shoulder instability. CT scan with 3D reconstruction reveals 28% anterior glenoid bone loss. Which of the following is the most appropriate surgical intervention?

A 45-year-old man presents to the ER after a generalized tonic-clonic seizure. He complains of right shoulder pain and is unable to externally rotate the arm past neutral. An axillary radiograph confirms a posterior shoulder dislocation with an impaction fracture of the anteromedial humeral head involving 35% of the articular surface. What is the most appropriate surgical treatment?

An MRI of a 24-year-old male with recurrent shoulder instability demonstrates a 'J-sign' with extravasation of contrast into the axillary pouch. There is no labral tear identified on the glenoid rim. This finding is most consistent with which of the following injuries?

The dynamic stability of the glenohumeral joint is maintained by muscular force couples. Which of the following muscle pairings constitutes the primary transverse plane force couple of the shoulder?

A 55-year-old man presents with chronic shoulder pain. An MRI reveals a massive, irreparable tear of the supraspinatus and infraspinatus tendons with grade 4 fatty infiltration. The subscapularis and teres minor are intact. The patient has preserved forward elevation but profound weakness in external rotation (positive Hornblower's sign). Which of the following tendon transfers is most appropriate to restore external rotation?

A 16-year-old female gymnast presents with bilateral shoulder pain. She describes a sensation of her shoulders 'slipping out of place' during routine activities. Examination reveals a positive sulcus sign, generalized ligamentous laxity, and symmetric multidirectional instability. What is the most appropriate initial management?

A 60-year-old man sustains an anterior shoulder dislocation. After closed reduction, he is noted to have isolated numbness over the lateral aspect of the shoulder and profound weakness in shoulder abduction. Which of the following muscles, in addition to the deltoid, is primarily denervated by this nerve injury?

A 40-year-old construction worker has an MRI of the shoulder demonstrating an articular-sided partial-thickness tear of the supraspinatus tendon involving 60% of the tendon footprint (PASTA lesion). He has failed 6 months of conservative treatment. What is the standard surgical management for this lesion?

A 22-year-old male sustains a recurrent anterior shoulder dislocation. MRI reveals a 10% anterior glenoid bone loss and a deep, engaging Hill-Sachs lesion. Which of the following procedures is indicated to directly address the humeral head defect and prevent it from engaging the anterior glenoid rim?

A 45-year-old man presents with chronic anterior shoulder pain and positive lift-off and belly-press tests. MRI demonstrates a chronic, massive, irreparable tear of the subscapularis tendon. The supraspinatus and infraspinatus are completely intact. Which tendon transfer is most commonly recommended to address this specific deficit?

A 32-year-old male is evaluated for chronic shoulder pain. On clinical examination, you suspect a SLAP tear. Which of the following provocative tests is characterized by the patient reporting deep shoulder pain when the arm is forward elevated to 90 degrees, adducted 10 degrees, and internally rotated against resistance, which then improves with external rotation?

A 24-year-old rugby player presents with recurrent anterior shoulder instability following a primary dislocation 2 years ago. Advanced imaging demonstrates a 26% anterior glenoid bone loss and an engaging Hill-Sachs lesion. What is the most appropriate definitive surgical management?

A 65-year-old woman sustains a 3-part proximal humerus fracture involving the surgical neck and greater tuberosity. The tuberosity fragment is displaced 1.5 cm superiorly. Which muscle group is the primary deforming force responsible for this superior displacement?