5. Sports Medicine MCQs

Which of the following is a recognized biomechanical or anatomic risk factor for non-contact anterior cruciate ligament (ACL) tears in female athletes?

A 45-year-old recreational tennis player presents with shoulder pain and weakness after a fall on an outstretched arm. Physical exam reveals increased passive external rotation compared to the contralateral side and a positive lift-off test. Which of the following physical examination tests would also most likely be positive?

A 24-year-old professional baseball pitcher experiences deep shoulder pain during the late cocking phase of throwing. MRI confirms a Type II SLAP lesion. Which of the following biomechanical mechanisms is most responsible for this specific injury in overhead throwing athletes?

A 16-year-old high school soccer player sustains a concussion and is progressing through a stepwise return-to-play protocol. During step 3 (sport-specific exercise), she develops a mild headache. What is the most appropriate next step in her management?

A 22-year-old female presents with recurrent instability 18 months after an anterior cruciate ligament (ACL) reconstruction. Physical examination reveals a positive Lachman and pivot-shift test. Radiographs and MRI suggest graft failure. What is the most common technical error leading to ACL graft failure?

A 21-year-old collegiate rugby player with a history of recurrent anterior shoulder dislocations presents for surgical evaluation. A 3D CT scan demonstrates a 27% anterior glenoid bone loss and an engaging Hill-Sachs lesion. Which of the following is the most appropriate surgical management?

A 55-year-old man feels a sudden 'pop' in the posterior aspect of his knee while squatting. MRI reveals a complete radial tear at the posterior root of the medial meniscus. If left untreated, this injury most closely mimics the biomechanical consequences of which of the following?

A high school football player sustains a concussion but conceals his symptoms to stay in the game. He subsequently takes another hit to the head and collapses, rapidly deteriorating into a coma. What is the primary pathophysiologic mechanism of Second Impact Syndrome?

A 45-year-old recreational tennis player has symptomatic failure of nonoperative management for an isolated Type II SLAP tear. In this specific demographic, which surgical intervention has been shown to yield the highest patient satisfaction and return to sport rates?

A 28-year-old skier presents with acute knee pain after a twisting injury. On physical examination, the dial test shows 15 degrees of increased external rotation on the injured side at 30 degrees of knee flexion, but symmetric external rotation at 90 degrees of flexion. This examination finding is most consistent with an isolated injury to which of the following structures?

Internal impingement of the shoulder in an elite overhead thrower typically involves the compression of which of the following structures during the late cocking/early acceleration phase?

A 16-year-old female presents with recurrent lateral patellar dislocations. Imaging demonstrates a normal TT-TG distance (12 mm) but an elevated Caton-Deschamps index of 1.5. Which of the following surgical procedures is most appropriate to address her specific pathoanatomy in addition to medial patellofemoral ligament (MPFL) reconstruction?

Following a sport-related concussion, an athlete is evaluated by the team physician. Which of the following factors at the time of initial injury is the strongest and most consistent predictor of a prolonged recovery (lasting greater than 14 days)?

A 25-year-old running back sustains a direct blow to the proximal tibia with his knee flexed. MRI confirms an isolated, Grade II injury of the posterior cruciate ligament (PCL). What is the most appropriate initial management?

An 11-year-old male presents with vague anterior knee pain and catching. Radiographs reveal an osteochondritis dissecans (OCD) lesion. In the knee, what is the most common anatomic location for an OCD lesion?

A 19-year-old collegiate hockey player suffers a first-time anterior shoulder dislocation. It is successfully reduced in the emergency department. If this athlete is treated non-operatively with a sling and physical therapy, what is his approximate risk of recurrent instability?

During the acute neurometabolic cascade of a sport-related concussion, indiscriminate release of excitatory neurotransmitters (such as glutamate) leads to a rapid ionic shift across the neuronal membrane. Which of the following best describes this immediate ionic and metabolic state?

When counseling a high school athlete on graft choices for an anterior cruciate ligament (ACL) reconstruction, the surgeon discusses bone-patellar tendon-bone (BPTB) autograft versus hamstring autograft. Which of the following postoperative complications is significantly more common with a BPTB autograft?

A 19-year-old college football player sustains a concussion during a game. Under current guidelines, when is it appropriate for him to begin a graduated return-to-play protocol?

A 20-year-old collegiate gymnast is undergoing anterior cruciate ligament (ACL) reconstruction. Which of the following graft choices is associated with the highest rate of postoperative anterior knee pain and difficulty kneeling?