Shoulder & Hip Sports MCQs

A 72-year-old woman sustains a 3-part proximal humerus fracture after a ground-level fall. Nonoperative management is initiated. During her first follow-up visit, she is found to have weakness with shoulder abduction and decreased sensation over the lateral aspect of her shoulder. Which of the following muscles shares its innervation with the muscle primarily affected by this neurological injury?

A 68-year-old man presents with chronic right shoulder pain and an inability to actively elevate his arm above 40 degrees. Passive elevation is preserved to 160 degrees. MRI demonstrates a massive, retracted tear of the supraspinatus and infraspinatus with advanced fatty infiltration (Goutallier stage 4), while the subscapularis and teres minor are intact. What is the most reliable surgical option to restore active forward elevation in this patient?

A 28-year-old overhead athlete complains of poorly localized posterior shoulder pain and paresthesias over the lateral deltoid. MRI of the shoulder reveals isolated atrophy and fatty infiltration of the teres minor muscle. Which of the following anatomic structures form the borders of the space where the affected nerve is likely compressed?

A 24-year-old elite volleyball player complains of vague posterior shoulder pain and weakness with overhead serving. Physical examination reveals atrophy of the infraspinatus but normal bulk of the supraspinatus. There is notable weakness in external rotation but normal abduction. An MRI shows a paralabral cyst. In which of the following anatomic locations is the cyst most likely compressing the involved nerve?

A 55-year-old manual laborer presents with chronic, intractable posterior shoulder pain and profound weakness in external rotation. He has a positive Hornblower's sign and a positive dropping sign. MRI demonstrates a massive, retracted, and irreparably atrophic tear of the infraspinatus and teres minor, with an intact subscapularis. Which of the following tendon transfers is most appropriate to restore external rotation in this patient?

A 28-year-old professional volleyball player presents with insidious onset of right shoulder pain and weakness. Examination reveals isolated atrophy of the infraspinatus muscle with normal bulk of the supraspinatus. MRI demonstrates a paralabral cyst. At which anatomic location is the nerve compression most likely occurring?

A 42-year-old man presents with a history of sudden, severe, unremitting right shoulder pain lasting for 2 weeks that woke him from sleep. The pain has now largely resolved, but he has noticed profound weakness in shoulder abduction and external rotation. There is no history of trauma. EMG at 4 weeks reveals acute denervation changes in the supraspinatus and deltoid. What is the most likely diagnosis and appropriate initial management?

A 24-year-old elite volleyball attacker complains of vague posterior shoulder pain and painless weakness over the past 6 months. Physical examination reveals notable atrophy of the infraspinatus fossa but normal bulk of the supraspinatus. She has full strength in shoulder abduction but 3/5 strength in external rotation with the arm at the side. An MRI is obtained, demonstrating a paralabral cyst. Where is the cyst most likely located and which nerve is affected?

A 26-year-old professional baseball pitcher undergoes shoulder arthroscopy for a Type II SLAP tear. During dynamic intraoperative testing, the surgeon observes a 'peel-back' mechanism of the superior labrum when the arm is placed in the late-cocking position (abduction and external rotation). This biomechanical phenomenon most directly leads to which of the following secondary shoulder pathologies in overhead athletes?

A 28-year-old professional tennis player presents with posterior shoulder pain and selective weakness in external rotation. An MRI of the shoulder reveals a multi-lobulated paralabral cyst located strictly within the spinoglenoid notch. Based on this isolated compression, which of the following clinical findings would most likely be observed on physical examination?

A 68-year-old woman presents with persistent shoulder pain and pseudoparalysis. MRI reveals a massive rotator cuff tear involving the supraspinatus and infraspinatus. Which of the following MRI findings is the strongest contraindication to a primary arthroscopic repair?

A 22-year-old elite collegiate baseball pitcher presents with vague posterior shoulder pain during the late cocking and early acceleration phases of throwing.

Physical examination reveals a loss of 25 degrees of internal rotation in the throwing arm compared to the contralateral side. He has a positive apprehension test that is relieved by a relocation maneuver. What is the most likely underlying pathophysiology of his pain?

A 28-year-old professional volleyball player complains of vague posterior shoulder pain and weakness with external rotation. An MRI (Figure 4) demonstrates a paralabral cyst in the spinoglenoid notch. Which of the following physical examination findings is most likely present?

A 60-year-old man undergoes arthroscopic rotator cuff repair. A Popeye deformity is a known potential outcome of biceps tenotomy. Compared to arthroscopic biceps tenodesis, which of the following is true regarding biceps tenotomy?

A 28-year-old elite volleyball player complains of vague, deep-seated posterior shoulder pain and weakness with overhead activities. Examination demonstrates marked atrophy of the infraspinatus fossa but normal bulk and tone of the supraspinatus. Significant weakness is noted in external rotation with the arm at the side, but abduction strength is symmetrically intact. MRI of the shoulder reveals a paralabral cyst. Based on the physical examination, where is the cyst most likely located?

A 55-year-old construction worker presents with a symptomatic type II SLAP tear and biceps tendinopathy. He undergoes arthroscopic biceps tenodesis. Compared to biceps tenotomy, which of the following is a recognized advantage of biceps tenodesis?

A 28-year-old professional volleyball player complains of insidious, deep posterior shoulder pain and weakness with external rotation. Clinical examination shows isolated atrophy of the infraspinatus fossa. MRI demonstrates a paralabral cyst causing nerve compression. Based on the examination findings, where is the cyst most likely located and what is the typical associated labral pathology?

A 30-year-old elite volleyball player presents with insidious onset of right shoulder pain and weakness. Physical examination reveals isolated atrophy of the infraspinatus muscle with normal bulk of the supraspinatus. Weakness is noted exclusively with external rotation. Where is the most likely location of nerve entrapment?

A 28-year-old elite volleyball player presents with isolated weakness in shoulder external rotation. She denies any shoulder pain. Physical examination reveals obvious atrophy of the infraspinatus, but supraspinatus strength and muscle bulk are normal. Where is the most likely site of nerve compression?

A 38-year-old man presents with a sudden onset of excruciating right shoulder pain that began 3 weeks ago without any antecedent trauma. The severe pain has now largely subsided, but he reports profound weakness in his shoulder. Physical examination reveals noticeable atrophy of the supraspinatus and infraspinatus, with significant weakness in external rotation and forward elevation. An MRI of the cervical spine and shoulder shows no structural pathology or compressive lesions. What is the most appropriate next step in management?