5. Sports Medicine MCQs

A 50-year-old man presents with chronic shoulder weakness. Clinical examination demonstrates a positive lift-off test and an asymmetric increase in passive external rotation compared to the contralateral side. Which rotator cuff tendon is predominantly injured?

A 45-year-old heavy laborer presents with a massive, irreparable posterosuperior rotator cuff tear. He has intact subscapularis function, active forward elevation to 140 degrees, and no glenohumeral arthritis. What is the most appropriate surgical management?

A 55-year-old man complains of weakness and pain in his shoulder following a fall. Examination demonstrates a positive 'belly-press' test and a positive 'lift-off' test. Which of the following structures is most likely injured?

A 35-year-old patient presents with a locked posterior shoulder dislocation after a seizure. CT reveals an anteromedial humeral head impression fracture (reverse Hill-Sachs lesion) involving 45% of the articular surface. What is the most appropriate surgical treatment?

A 24-year-old professional baseball pitcher complains of a 'dead arm' and pain during the late cocking phase of throwing. MR arthrography confirms an isolated Type II SLAP lesion. After 6 months of failed conservative therapy, what is the most appropriate surgical intervention?

A 20-year-old football player sustains an anterior shoulder dislocation. MRI reveals an avulsion of the anterior labroligamentous complex with an attached avulsed fragment of glenoid bone. What is the specific eponym for this lesion?

A 22-year-old collegiate baseball pitcher reports deep posterior shoulder pain during the late cocking phase of throwing. Arthroscopic evaluation reveals undersurface fraying of the rotator cuff. Where is this lesion most likely located?

During the physical examination of a patient with suspected rotator cuff pathology, which of the following tests is considered the most sensitive and specific for detecting an isolated tear of the upper border of the subscapularis tendon?

A 30-year-old professional volleyball player presents with painless weakness in external rotation of the right shoulder. Physical examination reveals isolated atrophy in the infraspinatus fossa, while supraspinatus strength and bulk are perfectly normal. At which anatomic location is nerve compression most likely occurring?

A 24-year-old man suffers an anterior shoulder dislocation. Prior to reduction, he has decreased sensation over the lateral aspect of his deltoid. Due to the involved nerve, which muscle's function must be most closely monitored for associated weakness?

A 22-year-old collision athlete presents with recurrent anterior shoulder instability. A 3D CT scan reveals 30% anterior glenoid bone loss. What is the most appropriate surgical intervention to minimize the risk of recurrent instability?

A 70-year-old man presents with chronic, massive, irreparable rotator cuff tears of the supraspinatus and infraspinatus. Physical examination reveals pseudoparalysis of the shoulder with active forward elevation limited to 40 degrees. MRI demonstrates Goutallier stage 4 fatty infiltration of the torn tendons, but the teres minor and subscapularis remain intact. Which of the following is the most appropriate surgical management?

A 24-year-old baseball pitcher complains of deep shoulder pain during the late cocking phase of throwing. MRI arthrogram reveals a Type II SLAP tear. Which of the following physical examination findings is most specific for identifying a SLAP lesion in this patient?

A 36-year-old volleyball player complains of vague posterior shoulder pain and profound weakness in external rotation. MRI reveals a large paralabral cyst located in the spinoglenoid notch. Which of the following muscle denervation patterns is most likely present?

A 22-year-old woman undergoes primary repair of a zone 2 flexor digitorum profundus (FDP) laceration. Postoperatively, she is started on an early active motion protocol. What is the primary benefit of this protocol compared to prolonged immobilization?

A 55-year-old manual laborer presents with persistent shoulder pain due to a symptomatic Type II SLAP tear that has failed conservative management. Given his age and occupation, which surgical procedure is associated with the most reliable clinical outcome and lowest rate of stiffness?

A 24-year-old professional baseball pitcher presents with vague anterior shoulder pain during the late cocking phase of throwing. The O'Brien test is positive, and MRI reveals a Type II SLAP lesion. What is the most appropriate initial management?

A 19-year-old college football player sustains an acute anterior shoulder dislocation. MRI confirms an anterior labral tear (Bankart lesion). If he is treated nonoperatively with a sling, what is his approximate risk of recurrent instability?

A 35-year-old man presents to the ER after a grand mal seizure. His shoulder is locked in internal rotation. An AP radiograph shows a 'lightbulb sign.' What is the most common associated bony defect in this injury pattern?

A 22-year-old rugby player has recurrent anterior shoulder instability. CT scan demonstrates 25% glenoid bone loss and a large, engaging Hill-Sachs lesion. What is the most appropriate definitive management?