Shoulder & Hip Sports MCQs

A 42-year-old recreational weightlifter complains of persistent deep anterior shoulder pain, particularly during bench press and biceps curls. Physical examination reveals a positive O'Brien test that is relieved when the test is repeated with the forearm in supination, and distinct tenderness in the bicipital groove. MRI reveals a Type II SLAP lesion with concomitant severe tenosynovitis and partial tearing of the long head of the biceps tendon. What is the most appropriate definitive surgical management for this patient?

A 19-year-old elite hockey player presents with gradual onset of deep groin pain exacerbated by hip flexion and internal rotation. Radiographs demonstrate a crossover sign and a prominent ischial spine sign. The alpha angle is measured at 45 degrees. Which of the following best describes the underlying morphologic abnormality and its typical associated labral and chondral pathology?

A 23-year-old rock climber presents with recurrent anterior shoulder instability. An MRI arthrogram shows an anteroinferior labral tear and a large posterolateral humeral head defect (Hill-Sachs lesion). A 3D CT scan reveals 12% anterior glenoid bone loss. On dynamic arthroscopic evaluation, the Hill-Sachs lesion 'engages' the anterior glenoid rim when the arm is placed in abduction and external rotation. Which of the following is the most appropriate surgical intervention?

A 25-year-old professional hockey player presents with chronic groin pain that worsens with prolonged sitting and deep hip flexion. Physical examination reveals a positive FADIR test. Radiographs demonstrate a pistol grip deformity of the proximal femur and an alpha angle of 65 degrees. Which of the following is the primary pathophysiologic mechanism for his intra-articular pathology?

A 21-year-old collegiate rugby player sustains recurrent anterior shoulder dislocations. An en face 3D CT reconstruction of the glenoid demonstrates 22% anterior glenoid bone loss. Which of the following surgical procedures is most appropriate to restore stability?

A 22-year-old collegiate baseball pitcher presents with vague posterior shoulder pain and a decline in pitching velocity. Physical exam reveals a positive O'Brien test and positive posterior impingement sign. A peel-back mechanism of the superior labrum is visualized on MRI arthrogram. Which of the following physical exam findings is most commonly associated with this pathology?

A 21-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. The surgeon plans an open Latarjet procedure. During the transfer of the coracoid process through the split in the subscapularis tendon, which of the following neurologic structures is at greatest risk of iatrogenic injury?

A 25-year-old professional hockey player undergoes hip arthroscopy for femoroacetabular impingement (FAI). Preoperative imaging demonstrated a prominent cam lesion with an alpha angle of 72 degrees. The surgeon performs an arthroscopic osteochondroplasty of the femoral head-neck junction. Resection of more than what percentage of the femoral neck diameter substantially increases the risk of a postoperative femoral neck fracture?

A 28-year-old elite male volleyball player presents with painless weakness of his dominant shoulder, noting a marked decrease in spiking power. Physical examination reveals normal forward elevation and abduction strength, but isolated profound weakness in external rotation. MRI reveals cystic fluid at the spinoglenoid notch. Which of the following muscles is expected to show denervation atrophy on electromyography (EMG)?

A 24-year-old professional rugby player presents with a history of recurrent anterior shoulder instability, having sustained 4 dislocations in the past year. Radiographic and CT imaging reveals a 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. What is the most appropriate surgical management to minimize his risk of recurrence?

A 21-year-old male hockey player presents with deep anterior groin pain that worsens with prolonged sitting and deep flexion activities. Physical exam is remarkable for a positive flexion, adduction, internal rotation (FADIR) test. Radiographs reveal an alpha angle of 65 degrees and a positive crossover sign. What is the most accurate description of his pathology?

A 25-year-old male undergoes a Latarjet procedure for recurrent anterior shoulder instability with 25% glenoid bone loss. Postoperatively, he presents with profound weakness in elbow flexion and decreased sensation over the lateral aspect of his forearm. Which of the following intraoperative maneuvers most likely caused this neurologic injury?

A 26-year-old male ice hockey player presents with insidious onset right groin pain, worsened by deep flexion and internal rotation. Examination demonstrates a positive FADIR test. Radiographs reveal a prominent bony bump at the anterolateral femoral head-neck junction with an alpha angle of 65 degrees. He undergoes arthroscopic osteochondroplasty for a cam deformity. During the resection of the femoral neck deformity, over-resection of the head-neck junction poses the greatest risk for which of the following complications?

A 24-year-old hockey player presents with persistent anterior groin pain exacerbated by hip flexion.

An AP pelvis radiograph reveals a prominent 'crossover sign'. What is the primary pathomorphology associated with this radiographic finding?

A 22-year-old elite hockey player presents with chronic, activity-limiting groin pain. An AP pelvis radiograph demonstrates a "crossover sign" and projection of the ischial spine into the pelvic basin. These radiographic findings are most indicative of which pathology?

A 24-year-old male athlete presents with deep anterior groin pain exacerbated by hip flexion and internal rotation. An AP pelvis radiograph demonstrates a crossover sign and a prominent ischial spine sign. The alpha angle on the lateral view is 45 degrees. These radiographic findings are most consistent with which of the following pathomorphologies?

A 28-year-old professional hockey player reports deep anterior groin pain that is exacerbated by hip flexion and internal rotation. An anteroposterior radiograph of the pelvis demonstrates a 'crossover sign'.

What is the primary pathophysiologic mechanism responsible for this patient's condition?

A 24-year-old collegiate hockey player presents with chronic anterior groin pain exacerbated by hip flexion and internal rotation. Anteroposterior pelvis radiographs reveal a prominent crossover sign and an ischial spine sign. Which of the following best describes the pathomorphology contributing to this patient's impingement?

A 22-year-old professional rugby player presents with recurrent anterior shoulder instability. Advanced imaging reveals a bony Bankart lesion with 28% glenoid bone loss and an engaging Hill-Sachs lesion. What is the most appropriate surgical management for this patient to prevent recurrent dislocation?