Shoulder & Hip Sports MCQs

A 65-year-old laborer has a massive, irreparable posterosuperior rotator cuff tear with an intact subscapularis, severe pseudoparalysis, and Hamada Grade 2 changes. Superior capsular reconstruction (SCR) is considered. Which structure provides the biomechanical basis for this procedure by keeping the humeral head reduced?

A 19-year-old female swimmer complains of bilateral shoulder pain and sensations of instability. Physical examination demonstrates generalized ligamentous laxity, positive sulcus sign, and apprehension in multiple planes. After 6 months of dedicated physical therapy, her symptoms persist. What is the surgical procedure of choice?

A 23-year-old minor league baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. MRI demonstrates a partial articular-sided supraspinatus tendon avulsion (PASTA) and posterosuperior labral fraying. This pathology is primarily driven by:

A 22-year-old rugby player presents with recurrent anterior shoulder instability. Advanced imaging reveals 30% anterior glenoid bone loss.

The most appropriate definitive surgical management is:

A 28-year-old professional baseball pitcher presents with a loss of throwing velocity and vague late-cocking phase shoulder pain. Examination reveals a 25-degree loss of internal rotation (GIRD) compared to the non-throwing shoulder. The primary pathophysiologic cause of this glenohumeral internal rotation deficit is:

A 19-year-old female gymnast presents with bilateral shoulder pain and a sensation of the shoulders 'slipping' during routines. Physical exam reveals a positive sulcus sign, positive apprehension tests with spontaneous relocation, and generalized ligamentous laxity. First-line management should focus on a rehabilitation program emphasizing strengthening of which of the following muscle groups?

A 60-year-old man presents with chronic shoulder weakness. MRI demonstrates a massive, retracted rotator cuff tear involving the supraspinatus and infraspinatus. Electromyography (EMG) shows denervation changes specifically isolated to the infraspinatus. Traction neuropathy of which nerve is most likely responsible for this finding?

A 25-year-old elite javelin thrower complains of posterior shoulder pain during the late cocking phase of throwing. Arthroscopy is performed for suspected internal impingement. Which of the following combined pathological findings is the hallmark of internal impingement of the shoulder?

A 20-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan demonstrates a 28% anterior glenoid bone loss and an engaging Hill-Sachs lesion. Which of the following is the most appropriate surgical management?

In patients with a massive, retracted rotator cuff tear involving the supraspinatus and infraspinatus tendons, traction neuropathy of the suprascapular nerve is most likely to occur at which of the following anatomic locations?

A 19-year-old collegiate football player sustains a first-time traumatic anterior shoulder dislocation.

What is the single most important risk factor for recurrent instability in this patient if treated nonoperatively?

A 28-year-old male volleyball player reports vague posterior shoulder pain and profound weakness with external rotation.

MRI demonstrates a large paralabral cyst located strictly within the spinoglenoid notch. Which muscle is primarily affected by this lesion?

A 25-year-old professional baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. Examination reveals a positive peel-back sign and increased external rotation with a deficit in internal rotation. What is the most likely diagnosis?

A 19-year-old collegiate hockey player presents with recurrent anterior shoulder instability. Preoperative evaluation determines an Instability Severity Index Score (ISIS) of 8. Which of the following surgical procedures is most appropriate to minimize his risk of recurrence?

A 28-year-old professional baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. Physical examination reveals a glenohumeral internal rotation deficit (GIRD) of 25 degrees. What is the primary pathophysiological mechanism contributing to this condition?

A 55-year-old male presents with shoulder pain and weakness after a fall. On examination, he has a positive "bear-hug" test and increased external rotation compared to the contralateral side. Which structure is most likely injured?

A 22-year-old collegiate baseball pitcher presents with vague posterior shoulder pain during the late cocking phase of throwing. Examination reveals a 25-degree loss of internal rotation (GIRD) compared to the non-throwing shoulder. Which of the following is the primary pathoanatomy responsible for this clinical presentation?

A 21-year-old rugby player presents with recurrent anterior shoulder instability. A CT scan of the shoulder reveals an engaging Hill-Sachs lesion and a 25% anterior glenoid bone defect.

What is the most appropriate definitive surgical management?

A 29-year-old professional volleyball player presents with isolated weakness in shoulder external rotation. MRI reveals a paralabral cyst compressing a nerve. At what anatomic location is this cyst most likely situated?

A 19-year-old collegiate baseball pitcher complains of posterior shoulder pain strictly during the late cocking phase of throwing. Examination reveals a 20-degree loss of internal rotation (GIRD) compared to the contralateral shoulder. What is the most likely pathomechanism of his pain?