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5. Sports Medicine MCQs

Practice Set 137 of 360

This practice set contains high-yield board review questions covering key concepts in 5. Sports Medicine. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 2721

Topic: 5. Sports Medicine

A 20-year-old basketball player reports a 6-month history of right groin pain that radiates into his testicles with activities of daily living. He denies any history of trauma. Examination reveals tenderness about the groin, and he has full hip range of motion. The abdomen is soft. Radiographs are normal. Nonsurgical management has consisted of rest and physical therapy, but he continues to have pain. What is the next step in management?

. Bone scan
. CT
. High-dose steroids
. Sacroiliac joint injection
. Hernia repair

Correct Answer & Explanation

. Hernia repair

Explanation

Sports hernias may be one of the most common causes of groin pain in athletes. Resisted hip adduction is painful in the case of groin disruption. Radiation of pain into the testicles and/or adductor region is often present. Sports hernias are associated with weakening of the posterior inguinal wall. In contrast with sports hernias, traditional or classic hernias can be readily detected on physical examination. Diagnostic imaging studies are not helpful and only serve to help exclude other diagnoses. Systemic high-dose steroids or sacroiliac joint injections have no role in treatment. High success rates have been reported for laparoscopic hernia repair in athletes. Kluin J, den Hoed PT, van Linschoten R, et al: Endoscopic evaluation and treatment of groin pain in the athlete. Am J Sports Med 2004;32:944-949. Genitsaris M, Goulimaris I, Sikas N: Laparoscopic repair of groin pain in athletes. Am J Sports Med 2004;32:1238-1242.

Question 2722

Topic: Shoulder & Hip Sports

A 55-year-old man who works as a carpenter reports chronic right anterior shoulder pain and weakness. Examination reveals 90 degrees of external rotation (with the arm at the side) compared to 45 degrees on the left side. His lift-off examination is positive, along with a positive belly press finding. An MRI scan reveals a chronic, retracted atrophied subscapularis tendon. What is the most appropriate management of his shoulder pain and weakness?

. Shoulder fusion
. Arthroscopic subscapularis repair
. Intra-articular corticosteroid injection
. Open subscapularis repair
. Pectoralis major transfer

Correct Answer & Explanation

. Pectoralis major transfer

Explanation

Chronic subscapularis tendon ruptures preclude primary repair. In such instances, subcoracoid pectoralis major tendon transfers may improve function and diminish pain. The subcoracoid position of the transfer allows redirection of the pectoralis major in a direction recreating the vector of the subscapularis tendon. Shoulder fusion is a salvage procedure, and corticosteroid injection may reduce pain but will not improve function. Jost B, Puskas GJ, Lustenberger A, et al: Outcome of pectoralis major transfer for the treatment of irreparable subscapularis tears. J Bone Joint Surg Am 2003;85:1944-1951.

Question 2723

Topic: 5. Sports Medicine

An 80-year-old man has had increasing shoulder pain for the past 4 months. He reports that it began with soreness and stiffness after chopping some wood. A coronal MRI scan is shown in Figure 16. Initial management should consist of

Shoulder Board Review 2002: High-Yield MCQs (Set 2) - Figure 3

. shoulder exercises, mild analgesics, and activity modification.
. transfer of the latissimus dorsi to the greater tuberosity.
. arthroscopy and debridement of the tendon edges.
. arthroscopy, arthroscopic acromioplasty, coracoacromial ligament release, and mini open repair.
. arthroscopy, arthrotomy, acromioplasty, and primary repair of the rotator cuff.

Correct Answer & Explanation

. shoulder exercises, mild analgesics, and activity modification.

Explanation

The MRI scan shows a massive tear of the supraspinatus tendon with medial retraction to the level of the glenoid. This is most likely an attritional tear with a high risk of failure of the repair. The preferred treatment is nonsurgical management for pain and stiffness. Acromioplasty and coracoacromial ligament release in this setting are controversial, as they can result in the devastating complication of anterosuperior subluxation of the humerus. Rockwood CA Jr, Williams GR Jr, Burkhead WZ Jr: Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg Am 1995;77:857-866.

Question 2724

Topic: Shoulder & Hip Sports

A 47-year-old man has acute right shoulder pain after falling off a ladder. The MRI scan shown in Figure 9 reveals

Anatomy 2005 Practice Questions: Set 1 (Solved) - Figure 23

. aseptic necrosis of the humeral head.
. a nondisplaced anatomic neck fracture.
. a partial-thickness rotator cuff tear.
. a full-thickness rotator cuff tear.
. a bony Bankart defect.

Correct Answer & Explanation

. a full-thickness rotator cuff tear.

Explanation

The MRI scan reveals a full-thickness rotator cuff tear with retraction and increased signal in the subacromial space indicating joint fluid. Herzog RJ: Magnetic resonance imaging of the shoulder. Instr Course Lect 1998;47:3-20.

Question 2725

Topic: 5. Sports Medicine

A 15-year-old female field hockey player sustains a blow to the mouth from a hockey stick. Three front teeth are knocked out and shown in Figure 4. In addition to calling a dentist immediately, what is the next best step in management?

Sports Medicine 2007 Practice Questions: Set 1 (Solved) - Figure 11

. Place the teeth in an ice water bath.
. Pour normal saline solution on the teeth and then place them in milk.
. Have the player gargle with mouthwash and place the teeth in water.
. Clean the teeth with a toothbrush and then reimplant them.
. Clean the teeth with a toothbrush and place them on ice.

Correct Answer & Explanation

. Pour normal saline solution on the teeth and then place them in milk.

Explanation

Tooth avulsions can occur in contact or collision sports. An avulsed tooth is a medical emergency. The likelihood of survival of the tooth depends on the length of time that the tooth is out of the socket and the degree to which the periodontal ligament is damaged. The tooth should be handled only by the crown end and not the root end. It can be rinsed of debris with water or normal saline solution. The tooth should not be brushed or cleaned otherwise. During transport, the tooth must be kept moist. An avulsed tooth can be transported in whole milk, saliva, sterile saline solution, or commercially available kits with physiologic buffer solutions. The tooth and the athlete should be transported to the dentist for reinsertion as soon as possible and preferably within an hour. Krasner P: Management of sports-related tooth displacements and avulsions. Dent Clin North Am 2000;44:111-135. Sullivan JA, Anderson SJ (eds): Care of the Young Athlete. Rosemont IL, American Academy of Orthopaedic Surgeons, Elk Grove Village, IL, American Academy of Pediatrics, 2000, p 190.

Question 2726

Topic: 5. Sports Medicine

A 35-year-old carpenter sustained an injury to his dominant shoulder in a fall. He reports that he felt a sharp tearing sensation as he held on to a scaffold to keep from falling. Examination reveals swelling and ecchymosis down the upper arm, weakness to internal rotation, and deformity of the anterior axilla. He has good strength in external rotation and no apprehension with instability testing. Radiographs are normal. Management should consist of

Upper Extremity 2005 Practice Questions: Set 1 (Solved) - Figure 13

. physical therapy for range of motion and strengthening following a decrease in pain and swelling.
. shoulder arthroscopy for diagnosis and treatment of a possible labral tear.
. open exploration and repair of a pectoralis major tendon avulsion.
. MRI of the rotator cuff.
. immobilization in a sling and swathe for 3 to 6 weeks, followed by mobilization and strengthening.

Correct Answer & Explanation

. open exploration and repair of a pectoralis major tendon avulsion.

Explanation

The findings are classic for a pectoralis major tendon avulsion. Deformity of the anterior axillary fold is a classic finding, and ecchymosis down the arm suggests that the injury is at the humeral attachment rather than at the musculotendinous junction. Good external rotation strength indicates that function in the supraspinatus and infraspinatus has been preserved. The treatment of choice for a tendon avulsion in a young individual is early surgical repair. Conversely, if the injury is within the muscle or at the musculotendinous junction, initial nonsurgical management is recommended. If the location of the injury cannot be determined by physical examination, then MRI of the pectoralis major can be helpful. Hanna CM, Glenny AB, Stanley SN, et al: Pectoralis major tears: Comparison of surgical and conservative treatment. Br J Sports Med 2001;35:202-206.

Question 2727

Topic: 5. Sports Medicine

Figure 13 shows the MRI scan of a 29-year-old rock climber who reports increasing shoulder pain and weakness. Based on these findings, atrophy will most likely occur in which of the following muscles?

Sports Medicine Board Review 2001: High-Yield MCQs (Set 2) - Figure 7

. Infraspinatus and supraspinatus
. Infraspinatus
. Supraspinatus
. Teres minor
. Deltoid

Correct Answer & Explanation

. Infraspinatus

Explanation

The MRI scan shows a cyst at the spinoglenoid notch. These cysts are often associated with a labral injury, such as a superior labrum anterior and posterior (SLAP) lesion. The suprascapular nerve passes through the suprascapular notch and sends motor branches to the supraspinatus and sensory branches to the capsule. At the spinoglenoid notch, the infraspinatus branch of the suprascapular nerve is compressed by the cyst, leading to isolated infraspinatus atrophy. The teres minor and the deltoid are innervated by the axillary nerve. Fehrman DA, Orwin JF, Jennings RM: Suprascapular nerve entrapment by ganglion cysts: A report of six cases with arthroscopic findings and review of the literature. Arthroscopy 1995;11:727-734. Ianotti JP, Ramsey ML: Arthroscopic decompression of a ganglion cyst causing suprascapular nerve compression. Arthroscopy 1996;12:739-745.

Question 2728

Topic: 5. Sports Medicine
A right-handed 24-year-old professional baseball player injured his left shoulder 6 weeks ago when he dove forward and landed hard with the arm extended. He reports that the shoulder "slipped out" and "went back in." The shoulder did not need to be reduced. He now reports deep pain in the front of the shoulder when batting on either side and is hesitant to raise his left arm up over his head to catch a ball. Examination reveals no obvious deformities of the shoulder and a somewhat guarded, limited range of motion in all planes. Provocative tests for the rotator cuff and labrum are equivocal. MRI scans are shown in Figures 16a and 16b. What is the best course of action?
. Physical therapy
. Arthroscopic labral repair
. Arthroscopic subscapularis repair
. Arthroscopic thermal capsular shift
. Open Bankart repair

Correct Answer & Explanation

. Physical therapy

Explanation

A hard fall on an outstretched arm often results in injury to the glenoid labrum. A significant tear of the anterior/inferior labrum often leads to instability, pain, and mechanical symptoms of the shoulder. The MRI scan shows no obvious labral tear or Hill-Sachs lesion to suggest an anterior dislocation. Recent clinical studies have suggested that early stabilization of initial anterior dislocations may lead to better results than nonsurgical management in young, athletic patients. However, there are no data to support early surgery for anterior labral tears resulting from traumatic subluxation without dislocation. Initial treatment should consist of a short period of rest and immobilization, followed by a physical therapy rehabilitation program designed to restore motion, strength, and dynamic stability to the shoulder. If the athlete cannot return to play following nonsurgical management, surgical repair of the labrum, either through an open or arthroscopic approach, is indicated.

Question 2729

Topic: Knee Sports

A 12 1/2-year-old boy reports intermittent knee pain and limping that interferes with his ability to participate in sports. He actively participates in football, basketball, and baseball. He denies any history of injury. Examination shows full range of motion without effusion. Radiographs reveal an osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. MRI scans are shown in Figures 14a and 14b. Initial treatment should consist of

. immobilization.
. arthroscopic evaluation of fragment stability.
. transarticular drilling of the lesion with 0.045 Kirschner wire.
. arthroscopic excision of the fragment and microfracture of underlying cancellous bone.
. excision of the fragment and mosaicplasty.

Correct Answer & Explanation

. immobilization.

Explanation

This skeletally immature patient has a small OCD lesion that appears stable, and he has not undergone any treatment. Therefore, a trial of immobilization until pain resolves is the best initial choice. Thereafter, cessation of sport activities for 4 to 6 months may allow healing of the lesion. Surgical treatment of juvenile OCD lesions is reserved for unstable lesions, patients who have not shown radiographic evidence of healing and are still symptomatic after 6 months of nonsurgical management, or patients who are approaching skeletal maturity. Good results with stable in situ lesions that have failed to respond to nonsurgical management have been reported with both transarticular and retroarticular drilling. Results after excision alone are poor at 5-year follow-up, and it is unclear if microfracture will improve the long-term outcome. Mosaicplasty may be the next best option for patients who remain or become symptomatic after excision of the fragment and microfracture. Wall E, Von Stein D: Juvenile osteochondritis dissecans. Orthop Clin North Am 2003;34:341-353.

Question 2730

Topic: 5. Sports Medicine

A 21-year-old soccer player reports pain and is unable to straighten his knee following an acute injury during a game. He is unable to continue to play. An MRI scan is shown in Figure 3. What is the next most appropriate step in management?

Sports Medicine 2007 Practice Questions: Set 1 (Solved) - Figure 8

. No weight bearing
. Cortisone injection
. Physical therapy
. Arthroscopic meniscectomy or repair
. Anterior cruciate ligament reconstruction

Correct Answer & Explanation

. Arthroscopic meniscectomy or repair

Explanation

The patient has a locked knee that cannot be fully extended. This is most likely the result of the mechanical block of a bucket-handle tear that has flipped into the notch. Also, the pain may be so severe that the muscle spasm prevents the knee from straightening out. When the patient is anesthetized, the muscle spasm relaxes and the meniscus can be reduced out of the notch. Arthroscopy is the treatment of choice. A meniscal repair is usually possible in large bucket-handle tears because the meniscus is torn in the red-red zone where most of the vascular supply is located. If the handle portion is badly frayed or damaged, a partial meniscectomy should be performed. The classic finding on MRI is a "double PCL sign." This is due to the flipped portion of the meniscus in the notch. Critchley IJ, Bracey DJ: The acutely locked knee: Is manipulation worthwhile? Injury 1985;16:281-283.

Question 2731

Topic: Shoulder & Hip Sports
A 21-year-old pitcher reports shoulder pain with hard throwing. He notes that the pain occurs in the early acceleration phase of his throw. Given his history, what structures are at greatest risk for injury?
. Posterosuperior labrum, greater tuberosity, articular side of the rotator cuff
. Posterior glenoid, humeral head, bursal side of the rotator cuff
. Biceps anchor, articular side of the rotator cuff, supraspinatus tendon
. Biceps tendon, bursal side of the rotator cuff, superior labrum
. Subscapularis, anterior labrum, humeral head

Correct Answer & Explanation

. Posterosuperior labrum, greater tuberosity, articular side of the rotator cuff

Explanation

Internal impingement in the thrower's shoulder occurs in the abducted, externally rotated position as described by Walch and associates. The injury is thought to occur from repetitive contact between the posterosuperior portion of the labrum and glenoid against the articular side of the rotator cuff and greater tuberosity.

Question 2732

Topic: 5. Sports Medicine

A patient with refractory long head biceps pain in the shoulder undergoes biceps tenotomy. The patient is concerned about possible postoperative deformity and loss of supination strength. Which of the following techniques provides the strongest initial fixation to prevent distal migration?

. Tenotomy with medial transfer
. Tenotomy with soft-tissue tenodesis
. Tenotomy with tenodesis using suture anchors
. Tenotomy with tenodesis using bone tunnels
. Tenotomy with tenodesis using an interference screw

Correct Answer & Explanation

. Tenotomy with tenodesis using an interference screw

Explanation

Recent articles have looked at the cyclic load failure and ultimate load failure of biceps tenodesis techniques. The interference screw has proved superior to bone tunnel, suture anchor, and soft-tissue tenodesis techniques in laboratory cadaveric testing. Whether this is clinically relevant or not is still unknown. Ozalay M, Akpinar S, Karaeminogullari O, et al: Mechanical strength of four different biceps tenodesis techniques. Arthroscopy 2005;21:992-998.

Question 2733

Topic: Shoulder & Hip Sports

A 22-year-old volleyball player has atrophy of the infraspinatus muscle. This deficit is the result of entrapment of what nerve?

. Axillary nerve in the posterolateral space
. Dorsal scapular nerve at the medial border of the scapula
. Suprascapular nerve in the scapular notch
. Suprascapular nerve in the spinoglenoid notch
. Subscapular nerve at the rotator interval

Correct Answer & Explanation

. Suprascapular nerve in the spinoglenoid notch

Explanation

Suprascapular deficits, as the result of repetitive forceful internal rotation with overhead ball striking, occur in the spinoglenoid notch. Compression interferes with distal suprascapular nerve innervation to the infraspinatus, while allowing the supraspinatus to function normally. A scapular notch entrapment of this nerve would involve both the supraspinatus and the infraspinatus. The axillary, dorsal scapular, and subscapular nerves do not affect the infraspinatus. Ferretti A, Cerullo G, Russo G: Suprascapular neuropathy in volleyball players. J Bone Joint Surg Am 1987;69:260-263.

Question 2734

Topic: 5. Sports Medicine

A 50-year-old competitive tennis player sustained a shoulder dislocation after falling on his outstretched arm 3 weeks ago. He now reports that he has regained motion but continues to have painful elevation and weakness in external rotation. A subacromial cortisone injection provided 3 weeks of relief, but the pain has returned. Which of the following studies will best aid in diagnosis?

Sports Medicine 2004 Practice Questions: Set 1 (Solved) - Figure 14

. CT
. Limited bone scan
. MRI
. Joint aspiration
. Functional capacity examination

Correct Answer & Explanation

. MRI

Explanation

Based on these findings, the most likely diagnosis is a rotator cuff injury and probable tear; therefore, MRI is the study of choice. CT is preferred for articular fractures. A bone scan is nonspecific and can identify inflammation or occult fracture. Joint aspiration is not likely to identify an effusion. Physical therapy and a functional capacity examination are used to identify weakness during recovery prior to a return to work or sports. Hawkins RJ, Bell RH, Hawkins RH, Koppert GJ: Anterior dislocation of the shoulder in the older patient. Clin Orthop 1986;206:192-195.

Question 2735

Topic: Shoulder & Hip Sports

A 73-year-old man who underwent repair of the left rotator cuff 6 years ago reports good pain relief but notes residual weakness of the left shoulder, especially with overhead tasks. He denies having pain at night and has minimal discomfort with activities of daily living but is dissatisfied with his shoulder strength. Radiographs show an acromiohumeral interval of 2 mm. Appropriate management should consist of

Shoulder 2002 Practice Questions: Set 1 (Solved) - Figure 8

. an exercise program.
. revision rotator cuff repair using local tissue transposition.
. revision rotator cuff repair using allograft.
. latissimus dorsi transfer.
. combined latissimus dorsi and teres major transfer.

Correct Answer & Explanation

. an exercise program.

Explanation

An exercise program to strengthen the deltoid and remaining rotator cuff will most likely offer the best results. Revision rotator cuff surgery yields better results in decreasing pain than improving strength and function, and this patient has only minimal pain. Tendon transfers, involving the use of the latissimus dorsi or teres major, have been used when the rotator cuff is deemed irreparable but are not indicated in elderly patients with minimal symptoms. Bigliani LU, Cordasco FA, McIlveen SJ, Musso ES: Operative treatment of failed repairs of the rotator cuff. J Bone Joint Surg Am 1992;74:1505-1515. DeOrio JK, Cofield RH: Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am 1984;66:563-567.

Question 2736

Topic: Knee Sports

Figures 18a and 18b show the radiographs of a 13-year-old baseball player who sustained a patellar dislocation with an associated lateral femoral condyle fracture. What ligament is attached to this fragment?

. Anterior cruciate
. Posterior cruciate
. Lateral collateral
. Oblique popliteal
. Intermeniscal

Correct Answer & Explanation

. Anterior cruciate

Explanation

The anterior cruciate ligament is attached to a portion of the lateral femoral condyle. The posterior cruciate ligament attaches to the medial femoral condyle. The lateral collateral and oblique popliteal ligaments attach proximal to this fragment. The intermeniscal ligament attaches the anterior horns of the menisci. Jobe CM, Wright M: Anatomy of the knee, in Fu FH, Harner CD, Vince KG (eds): Knee Surgery. Baltimore, MD, Williams & Wilkins, 1994, pp 1-54.

Question 2737

Topic: 5. Sports Medicine

A 17-year-old high school soccer player sustains an anterior cruciate ligament (ACL) tear at the beginning of the season. An MRI scan confirms a complete ACL tear with no meniscal injuries. The patient plans an early return to play and would like to avoid surgery. Therefore, the patient and family should be advised that nonsurgical management consisting of rehabilitative exercises and the use of a functional knee brace will most likely result in

Sports Medicine Board Review 2001: High-Yield MCQs (Set 2) - Figure 15

. recurrent buckling with a probable meniscal tear.
. limitation of motion with a delay in recovery.
. a full return to activity with no limitations.
. an improvement in overall performance.
. an uneventful completion of the soccer season.

Correct Answer & Explanation

. recurrent buckling with a probable meniscal tear.

Explanation

While there are athletes who can function at a full level with an ACL tear, they are in the minority. As yet, there is no reliable way to predict the patients who will be able to compensate for the loss of the ACL. Studies have confirmed the risk of recurrent instability and meniscal injury in athletes with an ACL-deficient knee who participate in cutting sports. One study showed that only 12 of 43 patients who attempted rehabilitation and bracing were able to return successfully for the season. Another study showed that 17 of 31 athletes who were able to return to their sport sustained 23 meniscal tears because of recurrent instability. Shelton WR, Barrett GR, Dukes A: Early season anterior cruciate ligament tears: A treatment dilemma. Am J Sports Med 1997;25:656-658.

Question 2738

Topic: Shoulder & Hip Sports

A 52-year-old man has had right shoulder pain in the deltoid region that increases at night for the past 2 months. He denies any history of trauma. Examination reveals mild tenderness over the greater tuberosity, and the Neer and Hawkins impingement signs are positive. AP and outlet lateral radiographs are shown in Figures 24a and 24b. Initial management should consist of

. a program of stretching exercises and rotator cuff strengthening exercises.
. a series of six cortisone injections.
. arthroscopic acromioplasty.
. arthroscopic acromioplasty and laser capsulorrhaphy.
. open acromioplasty.

Correct Answer & Explanation

. a program of stretching exercises and rotator cuff strengthening exercises.

Explanation

The patient has the findings of classic subacromial impingement. Initial management should consist of stretching exercises directed at the posterior capsule and a program of rotator cuff and deltoid strengthening exercises performed below the horizontal in a "safe" plane. The judicious use of subacromial cortisone injections (one or two) may be helpful. Anterior acromioplasty is reserved for patients who have failed to respond to nonsurgical management. Morrison DS, Frogameni AD, Woodworth P: Non-operative treatment of subacromial impingement syndrome. J Bone Joint Surg Am 1997;79:732-737. Neer CS: Impingement lesions. Clin Orthop 1983;173:70-77.

Question 2739

Topic: 5. Sports Medicine

A 16-year-old high school pitcher notes acute pain on the medial side of his elbow during a pitch. Examination that day reveals medial elbow tenderness, pain with valgus stress, mild swelling, and loss of extension. Plain radiographs show closed physes and no fracture. Which of the following diagnostic studies will best reveal his injury?

Shoulder 2002 Practice Questions: Set 1 (Solved) - Figure 12

. Technetium Tc 99m bone scan
. Contrast-enhanced MRI
. CT
. Electromyography
. Arthroscopy

Correct Answer & Explanation

. Contrast-enhanced MRI

Explanation

The history and findings are consistent with a diagnosis of a sprain of the medial collateral ligament (MCL) of the elbow; therefore, contrast-enhanced MRI is considered the most sensitive and specific study for accurately showing this injury. Arthroscopic visualization of the MCL is limited to the most anterior portion of the anterior bundle only; complete inspection of the MCL using the arthroscope is not possible. CT without the addition of contrast is of no value in this situation. Use of a technetium Tc 99m bone scan is limited to aiding in the diagnosis of occult fracture, a highly unlikely injury in this patient. There are no clinical indications for electromyography. Timmerman LA, Andrews JR: Undersurface tear of the ulnar collateral ligament in baseball players: A newly recognized lesion. Am J Sports Med 1994;22:33-36. Timmerman LA, Schwartz ML, Andrews JR: Preoperative evaluation of the ulnar collateral ligament by magnetic resonance imaging and computed tomography arthrography: Evaluation of 25 baseball players with surgical confirmation. Am J Sports Med 1994;22:26-32.

Question 2740

Topic: 5. Sports Medicine

An 18-year-old hockey player sustains an acute anterior shoulder dislocation that requires manual reduction. At arthroscopy, the lesion shown in Figure 24 will be observed in what percent of patients?

Sports Medicine 2004 Practice Questions: Set 3 (Solved) - Figure 3

. 20% to 30%
. 35% to 45%
. 50% to 60%
. 80% to 95%
. 100%

Correct Answer & Explanation

. 80% to 95%

Explanation

The clinical photograph shows an acute capsulolabral avulsion from the anterior glenoid, also referred to as a Perthes-Bankart lesion. In patients who sustain an acute dislocation that requires a manual reduction, this pathologic lesion is observed with high frequency. In several research studies, it has been visualized in 80% to 95% of patients at arthroscopy. Taylor DC, Arciero RA: Pathologic changes associated with shoulder dislocations: Arthroscopic and physical examination findings in first-time, traumatic anterior dislocations. Am J Sports Med 1997;25:306-311.

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