Shoulder & Hip Sports MCQs

A 32-year-old weightlifter presents with right shoulder pain and weakness after feeling a clunk during a heavy bench press exercise. He reports difficulty externally rotating the arm. A modified axillary radiograph is provided in Figure 5.

Imaging reveals a reverse Hill-Sachs lesion that involves approximately 25% of the articular surface. What is the most appropriate surgical management?

A 21-year-old rugby player presents with recurrent anterior shoulder instability following an initial dislocation one year ago. A 3D reconstructed CT scan of the glenoid demonstrates an 'inverted pear' appearance with approximately 26% anterior bone loss.

What is the most appropriate surgical intervention to prevent recurrent instability?

During hip arthroscopy for a 28-year-old hockey player with femoroacetabular impingement (FAI), an osteochondroplasty is performed for a large cam lesion at the femoral head-neck junction. Resection of more than what percentage of the femoral neck diameter substantially increases the risk of an iatrogenic postoperative femoral neck fracture?

A 35-year-old woman presents with persistent anterior hip pain. Imaging shows a positive crossover sign, a center-edge angle of 45 degrees, and a labral tear. Which of the following is the defining pathomechanical feature of this specific type of femoroacetabular impingement (FAI)?

A 24-year-old male presents with deep groin pain exacerbated by hip flexion and internal rotation. Radiographs demonstrate a 'pistol grip' deformity of the proximal femur. Which of the following radiographic parameters is most diagnostic of the Cam-type femoroacetabular impingement (FAI) suspected in this patient?

A 55-year-old man presents with right shoulder weakness after a fall on an outstretched arm. He specifically complains of difficulty tucking in his shirt behind his back and bringing his hand to his abdomen. Physical examination reveals a positive bear-hug test and increased passive external rotation compared to the contralateral side. Which of the following special tests is also most likely to be positive in this patient?

A 25-year-old professional baseball pitcher presents with vague posterior shoulder pain and a noted decrease in pitching velocity. Physical exam reveals a Glenohumeral Internal Rotation Deficit (GIRD) of 25 degrees compared to the non-throwing shoulder, along with a loss of total arc of motion. What is the most common pathomechanical cause of symptomatic GIRD contributing to internal impingement in the overhead throwing athlete?

A 22-year-old male rugby player presents with recurrent anterior shoulder instability after a primary dislocation 2 years ago. He reports 5 subsequent dislocations requiring closed reduction. A 3D CT scan of the shoulder is shown in Figure 14, demonstrating an 'inverted pear' glenoid with 27% anterior bone loss. What is the most appropriate definitive management?

A 24-year-old male collegiate hockey player complains of insidious onset, worsening deep right groin pain that is exacerbated by prolonged sitting and deep hip flexion. A radiograph is shown in Figure 19, demonstrating an abnormal alpha angle of 65 degrees. What is the primary pathophysiologic mechanism of chondral injury in this specific morphological variant of femoroacetabular impingement (FAI)?

A 22-year-old hockey player complains of insidious onset groin pain exacerbated by hip flexion and internal rotation. Anteroposterior radiographs of the pelvis reveal a lateral center-edge angle (LCEA) of 45 degrees and a positive crossover sign. What is the most likely diagnosis?

A 19-year-old female collegiate swimmer presents with bilateral shoulder pain and a feeling of joint 'looseness'. Physical examination reveals a positive sulcus sign that does not reduce with external rotation, and apprehension with both anterior and posterior translation. She has failed 6 months of supervised physical therapy. If surgical intervention is planned, what is the most appropriate procedure?

A 28-year-old professional volleyball player presents with an insidious onset of right shoulder weakness and vague posterior shoulder pain. Physical examination demonstrates isolated weakness in external rotation. Internal rotation and forward elevation are 5/5. There is noticeable atrophy of the infraspinatus fossa, while the supraspinatus fossa appears normal. MRI reveals a paralabral cyst. Where is the cyst most likely located?

A 28-year-old hockey player undergoes hip arthroscopy for a symptomatic CAM lesion (femoroacetabular impingement). Following the osteochondroplasty of the femoral head-neck junction, what complication is significantly increased if the resection depth exceeds 30% of the femoral neck diameter?

A 65-year-old man presents with chronic, profound shoulder weakness. MRI demonstrates a massive, retracted tear of the supraspinatus and infraspinatus tendons with Goutallier stage 4 fatty infiltration.

During attempted arthroscopic mobilization and lateral traction of these chronically retracted tendons, which neurologic structure is at greatest risk of stretch injury?

A 22-year-old rugby player undergoes an open Latarjet procedure for recurrent anterior shoulder instability with 25% glenoid bone loss. Postoperatively, he exhibits weakness in elbow flexion and supination, along with decreased sensation over the lateral aspect of the forearm. Which nerve was most likely injured during the procedure?

A 28-year-old recreational volleyball player presents with deep shoulder pain and clicking. An MR arthrogram demonstrates a SLAP tear characterized by a bucket-handle tear of the superior labrum that extends into the long head of the biceps tendon. According to the Snyder classification, what type of SLAP tear is this?

A 20-year-old rugby player undergoes an open Latarjet procedure for recurrent anterior shoulder instability with 25% glenoid bone loss. Postoperatively, the patient exhibits weakness with elbow flexion and forearm supination, accompanied by numbness over the lateral aspect of his forearm. Which nerve is most likely to have been injured during the retraction of the conjoint tendon?

A 22-year-old elite collegiate baseball pitcher presents with vague posterior shoulder pain, a 'dead arm' sensation, and a decrease in pitching velocity.

He is diagnosed with a Type II superior labrum anterior and posterior (SLAP) tear. What biomechanical mechanism is primarily responsible for the propagation of this specific lesion during the throwing cycle?

A 21-year-old collegiate hockey player complains of deep anterior groin pain exacerbated by hip flexion, adduction, and internal rotation (FADIR test).

An AP pelvis radiograph demonstrates a prominent 'crossover sign.' What specific morphological abnormality is most closely associated with this radiographic finding?

A 19-year-old female collegiate swimmer presents with bilateral shoulder pain and a sensation of "looseness" during her butterfly stroke. Physical examination reveals a positive Beighton score, positive sulcus signs bilaterally that do not reduce with external rotation, and apprehension with both anterior and posterior translation. What is the most appropriate initial management?