5. Sports Medicine MCQs

A 30-year-old baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. Examination shows a 25-degree deficit in internal rotation compared to the contralateral side. MRI arthrogram shows undersurface fraying of the posterior supraspinatus and a posterosuperior labral tear. What is the most likely diagnosis?

A 55-year-old man presents with anterior shoulder pain. On physical examination, he demonstrates weakness with internal rotation when the arm is placed behind the back and lifted away from the body. An MRI confirms an isolated full-thickness tear of the subscapularis tendon. Which physical examination test would also most likely be positive?

A 26-year-old woman complains of bilateral shoulder instability and pain. She has a history of joint hyperlaxity. Examination reveals a positive sulcus sign bilaterally and apprehension in multiple positions. She has failed 6 months of dedicated physical therapy. Which surgical intervention is most appropriate?

A 50-year-old overhead athlete is diagnosed with a Type II SLAP tear. After failing conservative treatment, he undergoes arthroscopic surgery. Which of the following treatments is most supported by current literature for this patient demographic?

Which of the following radiographic findings is most characteristic of a posterior shoulder dislocation on a standard anteroposterior (AP) view?

A 38-year-old man sustains an anterior shoulder dislocation resulting in a massive, retracted rotator cuff tear. He is manually reduced in the emergency department. Three weeks later, he continues to have severe weakness in external rotation and elevation. He has a positive Hornblower's sign. An MRI demonstrates a retracted tear involving the supraspinatus and infraspinatus with grade 3 fatty infiltration. Which of the following is the most appropriate treatment?

A 24-year-old competitive rugby player presents with recurrent anterior shoulder instability. A CT scan demonstrates 28% anterior glenoid bone loss. Which of the following is the most appropriate surgical management?

A 65-year-old man presents with inability to actively externally rotate his shoulder and a positive hornblower's sign following a massive rotator cuff tear. Assuming the subscapularis is intact and the tear is irreparable, which tendon transfer is most appropriate to restore external rotation?

A 30-year-old man sustained a posterior shoulder dislocation during a seizure. Radiographs reveal a reverse Hill-Sachs lesion involving 35% of the anterior humeral head articular surface. Which of the following is the most appropriate surgical intervention?

A 28-year-old volleyball player complains of isolated, painless weakness in external rotation of her dominant shoulder. MRI reveals a paralabral cyst in the spinoglenoid notch. Which of the following physical examination findings is most likely present?

A 19-year-old gymnast presents with bilateral shoulder pain and a sensation of "slipping." Examination shows a sulcus sign of 2 cm bilaterally, positive apprehension, and generalized ligamentous laxity. There is no history of a distinct traumatic dislocation. What is the most appropriate initial management?

A patient with a massive rotator cuff tear demonstrates "pseudoparalysis" of the shoulder, being unable to actively elevate the arm past 60 degrees. Anesthetic injection into the subacromial space does not improve active motion. What is the primary biomechanical deficit in this shoulder?

During an arthroscopic anterior stabilization procedure, the surgeon identifies an avulsion of the anterior labrum where the intact anterior scapular periosteum has stripped and displaced medially on the glenoid neck. What is the correct term for this lesion?

A 50-year-old man presents with a suspected subscapularis tendon rupture after a fall. Which of the following physical examination tests is most specific and sensitive for diagnosing a full-thickness tear of the upper border of the subscapularis tendon?

In the context of anterior shoulder instability, the "glenoid track" concept is used to determine whether a Hill-Sachs lesion will engage. Which of the following correctly defines an "off-track" Hill-Sachs lesion?

A superior capsular reconstruction (SCR) is planned for a 55-year-old laborer with an irreparable, massive supraspinatus and infraspinatus tear. To optimize the biomechanical success of the SCR, which of the following native structures MUST be intact or repairable?

A 21-year-old collegiate rugby player sustains a fourth anterior shoulder dislocation. A 3D CT scan reveals 25% anterior glenoid bone loss with an engaging Hill-Sachs lesion. Which of the following surgical procedures is most appropriate to minimize the risk of recurrent instability?

A 55-year-old man presents with persistent shoulder pain and profound weakness 3 weeks after an acute, first-time anterior glenohumeral dislocation. The dislocation was reduced in the emergency department, and radiographs confirm a concentric joint. Which of the following is the most common associated injury responsible for his current symptoms?

A 35-year-old man presents with a locked posterior shoulder dislocation after a generalized seizure. CT scan reveals an anterior articular impaction fracture (reverse Hill-Sachs lesion) involving 35% of the humeral head articular surface. Which of the following is the most appropriate treatment?

A 29-year-old male weightlifter complains of vague posterior shoulder pain and selective weakness in external rotation. An MRI reveals an isolated paralabral cyst at the spinoglenoid notch with associated muscle edema. The cyst most likely originated from which of the following?