Shoulder & Hip Sports MCQs

A 24-year-old overhead athlete undergoes an arthroscopic Bankart repair for recurrent anterior shoulder instability. Which of the following structural lesions must be addressed to minimize the risk of recurrent instability postoperatively?

Which of the following muscles is first affected in facioscapulohumeral dystrophy:

A 20-year-old collegiate wrestler undergoes an arthroscopic Bankart repair. During the procedure, an engaging Hill-Sachs lesion is noted that drops into the glenoid rim in abduction and external rotation. Which of the following procedures should be added to prevent recurrence?

A 24-year-old male sustains recurrent anterior shoulder dislocations. Imaging demonstrates an engaging Hill-Sachs lesion and 25% bone loss of the anterior inferior glenoid. What is the most appropriate surgical intervention?

During an arthroscopic Bankart repair for recurrent anterior shoulder instability, a large Hill-Sachs lesion is noted. This lesion is anatomically described as an impaction fracture of the:

A 21-year-old collegiate linebacker has a history of recurrent anterior shoulder dislocations. A 3D CT scan reveals 28% anterior glenoid bone loss and an engaging Hill-Sachs lesion. What is the most appropriate definitive surgical intervention?

A 20-year-old swimmer presents with recurrent anterior shoulder instability. An MRI arthrogram demonstrates an anterior labroligamentous avulsion where the anterior scapular periosteum remains intact but is stripped medially. Which lesion does this describe?

A 60-year-old patient undergoes an arthroscopic rotator cuff repair for a massive crescent-shaped tear. Biomechanically, what is the primary advantage of utilizing a double-row repair construct compared to a single-row repair?

A 28-year-old male with recurrent anterior shoulder instability is found to have a Hill-Sachs lesion on MRI. Which of the following best describes the anatomic nature of this lesion?

A 26-year-old professional volleyball player presents with insidious onset of posterior shoulder pain and isolated, profound weakness in external rotation. MRI reveals a paralabral cyst. In which anatomical location is the cyst most likely compressing the suprascapular nerve?

A 15-year-old boy presented with inability to elevate his right shoulder and flex his elbow. He sustained a fall from an all-terrain vehicle 8 weeks ago. He landed on the right shoulder and twisted his neck. Radiographs of the skull, chest, cervical and thoracic spine, and shoulder were normal. There was no loss of consciousness, chest pain, or breathing difficulties. The patient was observed in the hospital until stable and referred for follow-up in the hand clinic at 4 weeks. An electromyelogram (EMG) was scheduled. Clinical examination revealed weakness of deltoid, supraspinatus, infraspinatus, teres minor, biceps, brachialis, brachioradialis, and extensor carpi radialis longus. The remainder of his forearm musculature was preserved and he could grasp, release, and pinch. Sensations were decreased along the distribution of the axillary nerve. There was 3 cm wasting of his arm and 2 cm of the forearm. Tinel's sign is positive around the clavicle. Horner's signs are absent and his arm lies against the body. The EMG report showed fibrillation potentials in the weak muscles. The patient can now flex his elbow. When asked to demonstrate, he flexes his wrist and pronates his forearm to swing his elbow into flexion. The least helpful test in further management of this patient is:

A 15-year-old boy presented with inability to elevate his right shoulder and flex his elbow. He sustained a fall from an all-terrain vehicle 8 weeks ago. He landed on the right shoulder and twisted his neck. Radiographs of the skull, chest, cervical and thoracic spine, and shoulder were normal. There was no loss of consciousness, chest pain, or breathing difficulties. The patient was observed in the hospital until stable and referred for follow-up in the hand clinic at 4 weeks. An electromyelogram (EMG) was scheduled. Clinical examination revealed weakness of deltoid, supraspinatus, infraspinatus, teres minor, biceps, brachialis, brachioradialis, and extensor carpi radialis longus. The remainder of his forearm musculature was preserved and he could grasp, release, and pinch. Sensations were decreased along the distribution of the axillary nerve. There was 3 cm wasting of his arm and 2 cm of the forearm. Tinel's sign is positive around the clavicle. Horner's signs are absent and his arm lies against the body. The EMG report showed fibrillation potentials in the weak muscles. The patient can now flex his elbow. When asked to demonstrate, he flexes his wrist and pronates his forearm to swing his elbow into flexion. The most important indication for early exploration in this patient is:

A 4-month-old infant with obstetric brachial plexus palsy presents with an internal rotation contracture of the shoulder and complete absence of active biceps function. Wrist extension is also absent. What is the most appropriate next step in management?

A 40-year-old male presents with sudden, severe, unprovoked right shoulder pain lasting for 2 weeks. As the pain subsides, he notices profound weakness in shoulder abduction and external rotation. EMG demonstrates denervation potentials in the supraspinatus and infraspinatus muscles. What is the most likely diagnosis?

A 32-year-old professional volleyball player presents with an insidious onset of posterior shoulder pain and progressive weakness in external rotation. Clinical examination shows isolated atrophy of the infraspinatus muscle with a completely normal supraspinatus muscle bulk and strength. Where is the most likely site of nerve compression?

When evaluating a patient with recurrent anterior shoulder instability, what specifically defines an "off-track" Hill-Sachs lesion?

A 24-year-old overhead throwing athlete presents with posterior shoulder pain. Physical examination reveals a positive active compression test (O'Brien test) that elicits deep joint pain with the forearm pronated, which is relieved with the forearm in supination. What is the most likely associated finding on MR arthrography?

A 40-year-old male suffers a seizure and subsequently complains of severe right shoulder pain. Radiographs show a "lightbulb" sign on the AP view and an empty glenoid sign. What is the most common associated bony defect seen with this specific injury?

In the evaluation of anterior shoulder instability, an Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA) lesion differs from a classic Bankart lesion in which of the following ways?

A 15-year-old white boy presents to your office with inability to elevate his right shoulder and flex his elbow. He sustained a fall from an all-terrain vehicle 8 weeks ago. He landed on the right shoulder and says his neck was twisted away at the time of fall. He was seen at the local emergency department; skull, chest, cervical and thoracic spine, and shoulder X-rays showed no damage. There was no loss of consciousness and he has no chest pain or breathing difficulties. He was observed in the hospital until stable and was referred to follow up in the hand clinic at 4 weeks and scheduled for an electromyogram. Clinical examination reveals weakness of deltoid, supraspinatus, infraspinatus, teres minor, biceps, brachialis, brachioradialis, and extensor carpi radialis longus. The remainder of his forearm musculature is preserved and he can grasp and release and pinch. Sensations are decreased along the distribution of the axillary nerve. There is 3 cm wasting of his arm and 2 cm of his forearm. Tinel sign is positive around the clavicle. Horner signs are absent and his arm lies against the body. The EMG report shows fibrillation potentials in the weak muscles. The parents are concerned and say they have not seen any improvement. The boy reports that he is now able to flex his elbow. When asked to demonstrate you notice that he flexes his wrist and pronates his forearm to swing his elbow into flexion. What is the least helpful test in further management of this patient?