Shoulder & Hip Sports MCQs

A 38-year-old man presents with severe left shoulder pain and the arm locked in internal rotation after experiencing a generalized tonic-clonic seizure. An AP radiograph demonstrates a symmetric "lightbulb" appearance of the humeral head. What is the expected associated humeral head bone defect?

A 28-year-old professional volleyball player presents with insidious onset of vague posterolateral shoulder pain and isolated, visible atrophy of the infraspinatus fossa. MRI reveals a large paralabral cyst. Where is the most likely anatomic location of the nerve compression?

A 65-year-old patient suffers an anterior shoulder dislocation. After successful closed reduction, the patient demonstrates profound weakness in abduction and external rotation. Electromyography confirms axillary nerve neurapraxia. Which additional injury typically completes the "terrible triad of the shoulder" in this age group?

A 45-year-old man falls while skiing and presents with weakness in internal rotation. Physical examination demonstrates increased passive external rotation compared to the contralateral side and a positive belly-press test. Which structure is most likely injured?

When comparing double-row to single-row rotator cuff repair techniques, biomechanical studies consistently demonstrate that double-row constructs provide which of the following?

A 40-year-old man has a locked posterior shoulder dislocation that occurred 3 weeks ago. A CT scan reveals a reverse Hill-Sachs lesion involving 40% of the articular surface. What is the most appropriate surgical management?

A 25-year-old athlete has recurrent anterior shoulder instability despite a prior arthroscopic Bankart repair. An MRI arthrogram reveals extravasation of contrast extending inferiorly in the axillary pouch into the anatomic neck of the humerus forming a "J-sign". What is the most likely diagnosis?

A 28-year-old elite volleyball player presents with painless weakness in external rotation. Forward elevation is full and strong. MRI reveals a paralabral cyst in the spinoglenoid notch. Which labral pathology is most commonly associated with this finding?

During open reduction and internal fixation of a proximal humerus fracture via a deltopectoral approach, how does the axillary nerve typically course in relation to the operative field?

In evaluating a patient with anterior shoulder instability, the "glenoid track" concept is used to assess bone loss. A Hill-Sachs lesion is considered "off-track" if it:

A 22-year-old collegiate rugby player presents with his third episode of anterior shoulder dislocation. Advanced imaging reveals a 28% anteroinferior glenoid bone loss. Which of the following procedures is most appropriate to restore stability?

A 45-year-old male laborer sustained a massive, retracted, irreparable posterosuperior rotator cuff tear. He has intact subscapularis function, active forward elevation to 100 degrees, and no glenohumeral arthritis. Which of the following is the most appropriate surgical option to improve function?

A 30-year-old baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. Examination shows a 25-degree deficit in internal rotation compared to the contralateral side. MRI arthrogram shows undersurface fraying of the posterior supraspinatus and a posterosuperior labral tear. What is the most likely diagnosis?

A 55-year-old man presents with anterior shoulder pain. On physical examination, he demonstrates weakness with internal rotation when the arm is placed behind the back and lifted away from the body. An MRI confirms an isolated full-thickness tear of the subscapularis tendon. Which physical examination test would also most likely be positive?

A 26-year-old woman complains of bilateral shoulder instability and pain. She has a history of joint hyperlaxity. Examination reveals a positive sulcus sign bilaterally and apprehension in multiple positions. She has failed 6 months of dedicated physical therapy. Which surgical intervention is most appropriate?

Which of the following radiographic findings is most characteristic of a posterior shoulder dislocation on a standard anteroposterior (AP) view?

A 38-year-old man sustains an anterior shoulder dislocation resulting in a massive, retracted rotator cuff tear. He is manually reduced in the emergency department. Three weeks later, he continues to have severe weakness in external rotation and elevation. He has a positive Hornblower's sign. An MRI demonstrates a retracted tear involving the supraspinatus and infraspinatus with grade 3 fatty infiltration. Which of the following is the most appropriate treatment?

A 24-year-old competitive rugby player presents with recurrent anterior shoulder instability. A CT scan demonstrates 28% anterior glenoid bone loss. Which of the following is the most appropriate surgical management?

A 65-year-old man presents with inability to actively externally rotate his shoulder and a positive hornblower's sign following a massive rotator cuff tear. Assuming the subscapularis is intact and the tear is irreparable, which tendon transfer is most appropriate to restore external rotation?

A 30-year-old man sustained a posterior shoulder dislocation during a seizure. Radiographs reveal a reverse Hill-Sachs lesion involving 35% of the anterior humeral head articular surface. Which of the following is the most appropriate surgical intervention?