Shoulder & Hip Sports MCQs

A 22-year-old rugby player undergoes an open 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 forearm. Which nerve is most likely injured?

A 45-year-old manual laborer presents with an irreparable, massive posterosuperior rotator cuff tear. He has an intact subscapularis but profoundly weak external rotation and a positive hornblower's sign. What is the most appropriate tendon transfer to restore external rotation?

A 21-year-old collegiate baseball pitcher reports posterior shoulder pain during the late cocking phase of throwing. Exam reveals a Glenohumeral Internal Rotation Deficit (GIRD). Which of the following is the primary pathologic mechanism of internal impingement in this athlete?

A 35-year-old volleyball player presents with painless weakness in external rotation of the dominant shoulder. Examination shows isolated atrophy of the infraspinatus fossa with normal supraspinatus bulk. A paralabral cyst compressing a nerve is suspected. What is the most likely location of the cyst?

A 42-year-old man presents with a locked shoulder in internal rotation following a generalized seizure. An axillary lateral radiograph reveals a posterior dislocation with a reverse Hill-Sachs lesion involving 35% of the humeral head articular surface. What is the most appropriate surgical management?

A 21-year-old military recruit has a history of multiple recurrent anterior shoulder dislocations. Preoperative CT imaging shows 26% anterior glenoid bone loss. Which surgical procedure is most indicated to prevent further instability?

During a Latarjet procedure for anterior shoulder instability, the coracoid process is transferred to the anterior glenoid neck. The dynamic "sling effect" that stabilizes the shoulder during abduction and external rotation is provided primarily by which anatomical structure?

A 24-year-old elite volleyball attacker complains of persistent posterior shoulder pain. Physical examination reveals isolated weakness in external rotation with intact forward elevation strength. At which anatomical location is the involved nerve most likely being compressed?

A 45-year-old man presents with his shoulder locked in internal rotation following a generalized seizure. Radiographs confirm a posterior shoulder dislocation. A CT scan reveals a reverse Hill-Sachs lesion involving 35% of the anterior articular surface. What is the most appropriate surgical management?

A 22-year-old male rugby player presents with recurrent anterior shoulder instability. An MRI shows an anterior glenoid bone loss of 18% and a large Hill-Sachs lesion. Based on the glenoid track concept, if the Hill-Sachs lesion extends medial to the glenoid track, it is considered "off-track." Which of the following is the most appropriate surgical management for an off-track lesion in this high-demand athlete?

A 35-year-old elite volleyball player presents with vague posterior shoulder pain and weakness with external rotation. Examination reveals isolated atrophy of the infraspinatus with preserved supraspinatus bulk. Where is the most likely location of nerve compression?

A 55-year-old manual laborer presents with an irreparable posterosuperior rotator cuff tear. He has significant external rotation weakness and a positive hornblower's sign, but intact forward elevation (pseudoparesis of external rotation). The subscapularis is intact. Which of the following is the most appropriate tendon transfer for this patient?

A 40-year-old male presents with acute, severe, unremitting right shoulder pain lasting for 3 weeks, which has recently begun to subside. However, he now notices profound weakness in lifting his arm. Exam shows atrophy of the deltoid and supraspinatus. MRI of the shoulder is unremarkable. EMG shows denervation in the axillary and suprascapular nerve distributions. What is the most likely diagnosis?

A 24-year-old rugby player presents with recurrent anterior shoulder instability. CT scan reveals 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. Which of the following procedures is most appropriate?

A 28-year-old volleyball player presents with insidious onset of posterior shoulder pain and isolated weakness in external rotation. An MRI is obtained, demonstrating a paralabral cyst.

Based on the clinical presentation, where is the cyst most likely located and what labral pathology is associated with it?

A 55-year-old construction worker presents with insidious onset anterior shoulder pain, positive O'Brien's test, and MRI demonstrating a Type II SLAP tear. There is no significant rotator cuff tearing. What is the most reliable surgical intervention for this patient if conservative management fails?

A 23-year-old professional baseball pitcher presents with pain in the late cocking phase of throwing. MRI arthrogram reveals a partial articular-sided tear of the supraspinatus and fraying of the posterior superior labrum. What is the underlying pathophysiologic mechanism of this injury?

A 38-year-old laborer presents with an irreparable subscapularis tendon tear after a massive anterior shoulder injury. He has persistent pain and weakness in internal rotation. To restore internal rotation strength and dynamic anterior stability, a pectoralis major transfer is planned. To optimize the vector of pull, the transfer is typically routed:

A 22-year-old collegiate baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. MRI arthrogram reveals a peel-back lesion of the superior labrum. Which physical exam finding is most closely associated with this specific pathology?

A 26-year-old male sustains an acute, traumatic anterior shoulder dislocation. After successful closed reduction in the emergency department, he notes persistent numbness over the lateral aspect of his shoulder. Which muscle's function is most likely to be impaired?