Menu

5. Sports Medicine MCQs

Practice Set 186 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 3701

Topic: Shoulder & Hip Sports

A 45-year-old tennis player presents with persistent shoulder pain despite conservative management. MRI reveals a Partial Articular-Sided Supraspinatus Tendon Avulsion (PASTA) lesion that involves roughly 60% of the tendon thickness. What is the most appropriate surgical treatment?

. Subacromial decompression without rotator cuff intervention
. Debridement of the tear only
. Completion of the tear and formal repair (or in situ repair)
. Biceps tenodesis alone
. Latissimus dorsi tendon transfer

Correct Answer & Explanation

. Subacromial decompression without rotator cuff intervention

Explanation

Articular-sided partial rotator cuff tears involving greater than 50% of the tendon footprint thickness generally require surgical repair, either by completing the tear and repairing it or by performing a transtendon in situ repair.

Question 3702

Topic: Knee Sports

Biomechanical studies have demonstrated that a medial meniscus posterior root tear alters knee joint kinematics in a manner functionally equivalent to which of the following conditions?

. A partial meniscectomy leaving a 3-mm peripheral rim
. An isolated posterior cruciate ligament tear
. A total medial meniscectomy
. An anterior cruciate ligament tear
. A superficial medial collateral ligament rupture

Correct Answer & Explanation

. A partial meniscectomy leaving a 3-mm peripheral rim

Explanation

A complete tear of the medial meniscus posterior root abolishes hoop stresses within the meniscus, causing the meniscus to extrude. Biomechanically, this results in increased contact pressures equivalent to a total medial meniscectomy.

Question 3703

Topic: Knee Sports

A patient with knee instability is examined using the dial test. The examiner notes 15 degrees of increased external rotation of the affected limb compared to the normal limb at 30 degrees of knee flexion, but there is no side-to-side difference at 90 degrees of knee flexion. This finding strongly suggests an isolated injury to which structure?

. Anterior cruciate ligament
. Posterior cruciate ligament
. Posterolateral corner
. Superficial medial collateral ligament
. Popliteofibular ligament alone

Correct Answer & Explanation

. Anterior cruciate ligament

Explanation

An isolated posterolateral corner (PLC) injury presents with increased external rotation at 30 degrees of flexion but not at 90 degrees. If external rotation is increased at both 30 and 90 degrees, a combined PLC and PCL injury is present.

Question 3704

Topic: Knee Sports

Which component of the posterolateral corner (PLC) of the knee is the primary restraint to external rotation of the tibia at 30 degrees of knee flexion?

. Lateral collateral ligament (LCL)
. Popliteofibular ligament
. Iliotibial band
. Biceps femoris tendon
. Fabellofibular ligament

Correct Answer & Explanation

. Lateral collateral ligament (LCL)

Explanation

While the LCL is the primary restraint to varus stress, the popliteus complex (specifically the popliteofibular ligament and popliteus tendon) is the primary restraint to external tibial rotation.

Question 3705

Topic: Shoulder & Hip Sports

A 32-year-old elite volleyball player presents with isolated weakness in external rotation of his dominant shoulder. Physical examination reveals atrophy isolated to the infraspinatus fossa, with normal supraspinatus bulk and strength. Magnetic resonance imaging (MRI) is most likely to reveal a paralabral cyst causing nerve compression at which anatomical location?

. Suprascapular notch
. Spinoglenoid notch
. Quadrilateral space
. Triangular interval
. Spiral groove

Correct Answer & Explanation

. Suprascapular notch

Explanation

Compression of the suprascapular nerve at the spinoglenoid notch affects only its distal motor branch to the infraspinatus, causing isolated external rotation weakness and atrophy. Compression at the suprascapular notch would affect both the supraspinatus and infraspinatus.

Question 3706

Topic: Knee Sports

During an anatomic anterior cruciate ligament (ACL) reconstruction, failure to adequately recreate the posterolateral (PL) bundle will most likely result in a persistent deficit in which of the following biomechanical functions?

. Anterior translation at 90 degrees of flexion
. Varus stability near full extension
. Rotatory stability near full extension
. Posterior translation at 90 degrees of flexion
. Valgus stability at 30 degrees of flexion

Correct Answer & Explanation

. Anterior translation at 90 degrees of flexion

Explanation

The ACL consists of the anteromedial (AM) and posterolateral (PL) bundles. The PL bundle is tightest in extension and provides the primary restraint against rotatory loads, so failure to recreate it leads to persistent rotatory instability.

Question 3707

Topic: Shoulder & Hip Sports

The rotator cable is a thick band of capsuloligamentous tissue that transfers forces from the rotator cuff muscles to the humerus. According to the "suspension bridge" model proposed by Burkhart, in which of the following tear patterns is near-normal cuff kinematics most likely maintained?

. A tear involving only the anterior margin of the cable
. A tear disrupting the entire transverse span of the cable
. A tear located exclusively anterior to the cable
. A tear confined within the thinner crescent area with an intact cable
. A tear extending completely through the posterior cable

Correct Answer & Explanation

. A tear involving only the anterior margin of the cable

Explanation

Burkhart described the rotator cable as a suspension bridge that stress-shields the thinner, avascular crescent tissue. Tears confined strictly to the crescent area with an intact cable preserve the force transmission mechanism, often maintaining near-normal function.

Question 3708

Topic: 5. Sports Medicine
A 24-year-old professional athlete sustains an acute, isolated grade III posterior cruciate ligament (PCL) injury. If nonoperative management is chosen, which of the following rehabilitation protocols is most appropriate during the first 2 to 4 weeks?
. Immobilization in full extension
. Immobilization in 90 degrees of flexion
. Immediate open kinetic chain hamstring exercises
. Cast bracing locked in 30 degrees of flexion
. Early active resisted knee flexion

Correct Answer & Explanation

. Immobilization in full extension

Explanation

Initial nonoperative management for isolated PCL tears involves immobilization in full extension to counteract the posterior pull of the hamstrings and prevent posterior tibial sag. Open kinetic chain hamstring exercises are strictly avoided early on as they exacerbate posterior translation.

Question 3709

Topic: Knee Sports
A 22-year-old collegiate football player sustains a valgus blow to the knee. Physical examination reveals a grade III medial collateral ligament (MCL) sprain with significantly increased valgus laxity at both 0 and 30 degrees of knee flexion. This finding implies a concomitant injury to which of the following structures?
. Anterior cruciate ligament (ACL)
. Posterior oblique ligament (POL)
. Lateral collateral ligament (LCL)
. Popliteus tendon
. Iliotibial band

Correct Answer & Explanation

. Posterior oblique ligament (POL)

Explanation

Valgus laxity isolated to 30 degrees of flexion indicates a superficial MCL tear. Additional valgus laxity at 0 degrees of extension strongly implies concomitant injury to the posterior oblique ligament (POL) and the posteromedial capsule.

Question 3710

Topic: 5. Sports Medicine

When comparing bone-patellar tendon-bone (BTB) autograft to quadrupled hamstring autograft for ACL reconstruction, which of the following is a recognized characteristic of the BTB autograft?

. Lower risk of postoperative anterior knee pain
. Decreased risk of contralateral ACL rupture
. Higher incidence of physiological knee laxity
. Faster graft incorporation due to bone-to-bone healing
. Absence of risk for patellar fracture

Correct Answer & Explanation

. Lower risk of postoperative anterior knee pain

Explanation

BTB autografts facilitate rapid bone-to-bone healing in the osseous tunnels, typically integrating within 6 to 8 weeks. However, they are associated with a higher incidence of donor-site morbidity, including anterior knee pain and kneeling discomfort.

Question 3711

Topic: Shoulder & Hip Sports

Accurate anatomic restoration is critical during rotator cuff repair. The native footprint of the supraspinatus tendon on the greater tuberosity is best described as having which of the following approximate dimensions?

. 5 mm medial-to-lateral and 30 mm anterior-to-posterior
. 16 mm medial-to-lateral and 25 mm anterior-to-posterior
. 25 mm medial-to-lateral and 16 mm anterior-to-posterior
. 30 mm medial-to-lateral and 5 mm anterior-to-posterior
. 10 mm medial-to-lateral and 10 mm anterior-to-posterior

Correct Answer & Explanation

. 5 mm medial-to-lateral and 30 mm anterior-to-posterior

Explanation

The supraspinatus insertion footprint is roughly triangular, measuring approximately 16 mm in the medial-to-lateral dimension and 25 mm anterior-to-posterior. Understanding this anatomy is critical for achieving adequate footprint coverage during surgical repair.

Question 3712

Topic: Knee Sports

During the evaluation of a suspected posterolateral corner (PLC) knee injury, the dial test is performed. An increase in external rotation of 15 degrees at 30 degrees of knee flexion, but no asymmetry at 90 degrees of flexion, most strongly suggests which of the following injury patterns?

. Isolated PCL tear
. Combined PCL and PLC tear
. Isolated PLC tear
. Isolated ACL tear
. Combined ACL and PLC tear

Correct Answer & Explanation

. Isolated PCL tear

Explanation

An increase in external rotation of greater than 10-15 degrees at 30 degrees of flexion compared to the contralateral side indicates an isolated posterolateral corner (PLC) injury. If the asymmetry persists or increases at 90 degrees, it indicates a combined PCL and PLC injury.

Question 3713

Topic: Shoulder & Hip Sports

In the evaluation of a partial-thickness articular-sided rotator cuff tear (PASTA lesion), surgical repair (either via transtendinous technique or tear completion) is generally indicated over simple arthroscopic debridement when the tear involves what percentage of the native tendon thickness?

. Greater than 10%
. Greater than 25%
. Greater than 50%
. Greater than 75%
. Greater than 90%

Correct Answer & Explanation

. Greater than 10%

Explanation

Surgical repair is generally indicated for partial-thickness rotator cuff tears that involve >50% of the tendon thickness (approximately 7-8 mm of the footprint). Tears involving <50% are typically managed with arthroscopic debridement if nonoperative measures fail.

Question 3714

Topic: Shoulder & Hip Sports

The Goutallier classification is utilized on imaging to grade fatty infiltration of the rotator cuff muscles, which correlates with repair prognosis. Which Goutallier grade is specifically defined as having more fat than muscle within the muscle belly?

. Grade 1
. Grade 2
. Grade 3
. Grade 4
. Grade 5

Correct Answer & Explanation

. Grade 1

Explanation

In the Goutallier classification, Grade 3 denotes equal amounts of fat and muscle. Grade 4 is strictly defined as having more fat than muscle within the muscle belly, indicating a poor prognosis for structural healing.

Question 3715

Topic: 5. Sports Medicine

A 10-year-old boy (Tanner stage I) sustains a midsubstance ACL rupture and experiences recurrent giving-way episodes despite bracing. What is the most appropriate surgical intervention to stabilize the knee while minimizing the risk of iatrogenic growth arrest?

. Nonoperative bracing until skeletal maturity
. Transphyseal bone-patellar tendon-bone autograft
. Iliotibial band extra-articular tenodesis alone
. Physeal-sparing all-epiphyseal ACL reconstruction
. Standard adult-type transphyseal hamstring autograft

Correct Answer & Explanation

. Nonoperative bracing until skeletal maturity

Explanation

In skeletally immature patients with significant remaining growth (Tanner stage I or II), a physeal-sparing all-epiphyseal ACL reconstruction is recommended. This avoids drilling across the open physes, minimizing the risk of physeal arrest and subsequent angular deformities.

Question 3716

Topic: 5. Sports Medicine

Which of the following physical examination maneuvers is considered the most sensitive test for diagnosing a superior partial tear of the subscapularis tendon?

. Lift-off test
. Belly-press test
. Bear-hug test
. Neer impingement sign
. Speed's test

Correct Answer & Explanation

. Lift-off test

Explanation

The bear-hug test isolates the superior portion of the subscapularis and is highly sensitive and specific for upper subscapularis tears. The lift-off and belly-press tests are less sensitive for superior tears and better at detecting lower or massive complete tendon ruptures.

Question 3717

Topic: Knee Sports

A 24-year-old skier sustains a twisting injury to the knee. A plain radiograph is shown in Figure 1.

The image reveals an avulsion fracture of the lateral tibial plateau (Segond fracture). This pathognomonic finding is most strongly associated with injury to which of the following structures?

. Anterior cruciate ligament (ACL)
. Posterior cruciate ligament (PCL)
. Lateral collateral ligament (LCL)
. Medial collateral ligament (MCL)
. Popliteus tendon

Correct Answer & Explanation

. Anterior cruciate ligament (ACL)

Explanation

A Segond fracture is a cortical avulsion of the anterolateral capsular structures from the lateral tibial plateau. It is highly associated (75-100%) with an anterior cruciate ligament (ACL) tear.

Question 3718

Topic: Shoulder & Hip Sports

A 65-year-old man presents with chronic weakness in external rotation and abduction. MRI reveals a massive, retracted tear of the supraspinatus and infraspinatus. Retraction of these tendons medial to the glenoid places which nerve at greatest risk of tethering and subsequent injury?

. Axillary nerve
. Suprascapular nerve
. Radial nerve
. Musculocutaneous nerve
. Long thoracic nerve

Correct Answer & Explanation

. Axillary nerve

Explanation

Massive, retracted rotator cuff tears of the supraspinatus and infraspinatus can tether the suprascapular nerve. This most commonly occurs at the suprascapular notch or spinoglenoid notch, leading to denervation and further atrophy.

Question 3719

Topic: Knee Sports

A patient presents with knee pain and instability after a dashboard injury. The dial test shows 15 degrees of increased external rotation of the tibia at 30 degrees of knee flexion compared to the contralateral side, but symmetric external rotation at 90 degrees. What is the most likely diagnosis?

. Isolated posterolateral corner (PLC) injury
. Combined ACL and PLC injury
. Combined PCL and PLC injury
. Isolated PCL injury
. Isolated MCL injury

Correct Answer & Explanation

. Isolated posterolateral corner (PLC) injury

Explanation

The dial test with increased external rotation at 30 degrees but not 90 degrees indicates an isolated posterolateral corner (PLC) injury. If external rotation is increased at both 30 and 90 degrees, it suggests a combined PCL and PLC injury.

Question 3720

Topic: Shoulder & Hip Sports

A 45-year-old weightlifter feels a pop in his anterior shoulder while bench pressing. On examination, he has increased passive external rotation and a positive lift-off test. Which tendon is most likely injured?

. Supraspinatus
. Infraspinatus
. Teres minor
. Subscapularis
. Biceps long head

Correct Answer & Explanation

. Supraspinatus

Explanation

The subscapularis is the primary internal rotator of the shoulder. Injury results in increased passive external rotation and weakness in internal rotation, which is clinically demonstrated by a positive lift-off, belly-press, or bear-hug test.

Test Yourself

Switch to an interactive, timed exam simulation to truly master this topic.

On this Page