5. Sports Medicine MCQs

A 21-year-old baseball pitcher presents with deep shoulder pain during the late cocking phase of throwing. MRI arthrogram reveals a Type II SLAP tear. After 3 months of physical therapy focusing on periscapular stabilization and posterior capsular stretching, his symptoms persist. What is the most appropriate surgical intervention?

A 16-year-old high school football player sustains a mild concussion. He returns to play the following week while still experiencing mild headaches. During the game, he receives a minor blow to the chest, collapses, and falls into a coma. What is the primary pathophysiologic mechanism of this rapid decline?

A 22-year-old baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. On examination, he has pain with abduction and external rotation, which is relieved by a relocation maneuver. What is the most likely underlying arthroscopic finding?

A 22-year-old soccer player undergoes an acute ACL reconstruction along with a meniscal repair for a vertical longitudinal tear in the red-red zone of the medial meniscus. Which of the following factors is most strongly associated with successful healing of this meniscal tear?

A 17-year-old female experiences recurrent lateral patellar dislocations. Evaluation reveals a tibial tubercle-trochlear groove (TT-TG) distance of 22 mm and a normal Patellar Height (Caton-Deschamps index 1.0). Which surgical intervention is most appropriate to address her instability?

A 14-year-old male presents with knee pain. Radiographs show an osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. His physes are open, and MRI shows no high T2 signal behind the lesion. What is the most appropriate initial management?

A 25-year-old sustains a direct blow to the anteromedial tibia with the knee in extension. Examination reveals a grade 3 varus stress test at 30 degrees of flexion and a positive dial test at 30 degrees. However, at 90 degrees of flexion, the dial test is symmetric to the contralateral side. Which structures are most likely injured?

A 17-year-old soccer player collides head-to-head with an opponent and falls. He reports transient dizziness and a headache but denies any loss of consciousness. On sideline evaluation using the SCAT5, he has difficulty with delayed recall. What is the most appropriate next step in management?

A 28-year-old professional volleyball player presents with insidious onset of posterior shoulder pain and weakness. Examination reveals isolated weakness in external rotation with the arm at the side. MRI demonstrates a paralabral cyst at the spinoglenoid notch. Which muscle is most likely to show denervation changes on EMG?

A 68-year-old man underwent an anatomic total shoulder arthroplasty via a deltopectoral approach 6 weeks ago. He now complains of new-onset weakness and a sensation of anterior instability. On examination, he has increased passive external rotation compared to the contralateral side and a positive belly-press test. Failure of which of the following structures is most likely responsible?

A 21-year-old male contact athlete presents with recurrent anterior shoulder instability. CT scan with 3D reconstruction reveals 28% anterior glenoid bone loss. Which of the following is the most appropriate surgical intervention?

A 45-year-old man presents to the ER after a generalized tonic-clonic seizure. He complains of right shoulder pain and is unable to externally rotate the arm past neutral. An axillary radiograph confirms a posterior shoulder dislocation with an impaction fracture of the anteromedial humeral head involving 35% of the articular surface. What is the most appropriate surgical treatment?

An MRI of a 24-year-old male with recurrent shoulder instability demonstrates a 'J-sign' with extravasation of contrast into the axillary pouch. There is no labral tear identified on the glenoid rim. This finding is most consistent with which of the following injuries?

The dynamic stability of the glenohumeral joint is maintained by muscular force couples. Which of the following muscle pairings constitutes the primary transverse plane force couple of the shoulder?

A 55-year-old man presents with chronic shoulder pain. An MRI reveals a massive, irreparable tear of the supraspinatus and infraspinatus tendons with grade 4 fatty infiltration. The subscapularis and teres minor are intact. The patient has preserved forward elevation but profound weakness in external rotation (positive Hornblower's sign). Which of the following tendon transfers is most appropriate to restore external rotation?

A 16-year-old female gymnast presents with bilateral shoulder pain. She describes a sensation of her shoulders 'slipping out of place' during routine activities. Examination reveals a positive sulcus sign, generalized ligamentous laxity, and symmetric multidirectional instability. What is the most appropriate initial management?

A 60-year-old man sustains an anterior shoulder dislocation. After closed reduction, he is noted to have isolated numbness over the lateral aspect of the shoulder and profound weakness in shoulder abduction. Which of the following muscles, in addition to the deltoid, is primarily denervated by this nerve injury?

A 40-year-old construction worker has an MRI of the shoulder demonstrating an articular-sided partial-thickness tear of the supraspinatus tendon involving 60% of the tendon footprint (PASTA lesion). He has failed 6 months of conservative treatment. What is the standard surgical management for this lesion?