Shoulder & Hip Sports MCQs

The biomechanical 'suspension bridge' concept of the rotator cuff relies on force couples to maintain the humeral head centered on the glenoid. Which two muscles form the primary force couple in the transverse plane?

An 18-year-old female gymnast complains of bilateral shoulder pain and a sensation of 'slipping'. On exam, she has a positive sulcus sign and apprehension in multiple positions. Beighton score is 6/9. What is the most appropriate initial management?

A 31-year-old man suffers a traumatic anterior shoulder dislocation. MRI reveals a 'J-sign' involving the inferior glenohumeral ligament (IGHL) complex. This indicates a Humeral Avulsion of the Glenohumeral Ligament (HAGL) lesion. Which of the following is true regarding this condition?

A patient presents with anterior shoulder pain exacerbated by internal rotation and forward elevation. MRI demonstrates a narrowed coracohumeral interval (<6 mm). Subcoracoid impingement syndrome is suspected. This condition is most strongly associated with pathology of which structure?

The Latarjet procedure provides stability through a 'triple effect'. Which structure provides the dynamic 'sling effect' when the arm is abducted and externally rotated?

A 45-year-old heavy laborer has a massive, retracted, and irreparable subscapularis tendon tear. He complains of severe weakness with lifting objects in front of his body. Which tendon transfer is the most appropriate primary option to restore function?

A 55-year-old physically active man presents with an irreparable posterosuperior rotator cuff tear (supraspinatus and infraspinatus). The subscapularis is completely intact, and there is no glenohumeral arthritis. He has a severe external rotation lag. Which tendon transfer is most appropriate?

The 'terrible triad' of the shoulder is a distinct clinical entity commonly seen in middle-aged or older patients following high-energy trauma. Which three injuries comprise this triad?

A 21-year-old collegiate rugby player presents with his fourth anterior shoulder dislocation. A 3D CT scan is obtained to evaluate bone stock.

The imaging reveals 25% anterior glenoid bone loss. What is the most appropriate definitive surgical management?

A 28-year-old offensive lineman presents with deep posterior shoulder pain and clicking during bench pressing. Examination reveals a positive jerk test. If an MRI arthrogram is obtained, it is most likely to show a labral tear at which clock-face location on the right glenoid?

A 45-year-old male presents with acute shoulder pain and weakness after falling on an outstretched arm while skiing. Physical examination demonstrates increased passive external rotation compared to the contralateral side and a positive belly-press test. Which of the following structures is most likely injured?

A 24-year-old male is undergoing arthroscopic evaluation for recurrent anterior shoulder instability. Diagnostic arthroscopy reveals an 'engaging' Hill-Sachs lesion, but pre-operative CT scan showed minimal glenoid bone loss (<10%). Which of the following is the most appropriate management strategy?

A 19-year-old gymnast presents with bilateral shoulder pain and a sensation of her shoulders 'slipping' during routines. She has a positive sulcus sign bilaterally and generalized ligamentous laxity. Supervised physical therapy has failed to improve her symptoms after 6 weeks. What is the next best step in management?

During an arthroscopic rotator cuff repair, the surgeon evaluates the normal anatomical footprint on the greater tuberosity. Which of the following best describes the normal insertion site of the supraspinatus tendon?

A 22-year-old rugby player has recurrent anterior shoulder instability. CT scan with 3D reconstruction demonstrates 25% anterior glenoid bone loss. What is the most appropriate definitive management?

A 70-year-old man presents with an inability to actively elevate his right arm above 45 degrees, though passive elevation is full. Radiographs show superior migration of the humeral head with an acromiohumeral interval of 3 mm. MRI confirms a massive, retracted rotator cuff tear with Goutallier grade 4 fatty infiltration of the supraspinatus and infraspinatus. What is the best treatment option?

A 45-year-old man presents with anterior shoulder pain and weakness after a forceful external rotation injury. He demonstrates increased passive external rotation compared to the contralateral side. Which physical examination test is most sensitive and specific for his likely injury?

In the setting of recurrent anterior shoulder instability, the addition of an arthroscopic remplissage (infraspinatus tenodesis) to a Bankart repair is most appropriately indicated for which of the following scenarios?

A 50-year-old laborer undergoes a latissimus dorsi tendon transfer for an irreparable posterosuperior rotator cuff tear. To function effectively, the transferred latissimus dorsi primarily replicates the function of which native muscle?

A 28-year-old volleyball player presents with posterior shoulder pain and weakness in external rotation. MRI reveals a paralabral cyst in the spinoglenoid notch and a superior labral tear. Which physical examination finding is most likely to be present?