5. Sports Medicine MCQs

A 30-year-old overhead athlete presents with insidious onset, vague posterior shoulder pain. Examination reveals normal strength in forward elevation and internal rotation, but objective weakness in external rotation. An MRI reveals a paralabral cyst in the spinoglenoid notch. What is the underlying pathology causing this weakness?

A 28-year-old woman presents with bilateral shoulder pain and feelings of instability. She has a positive sulcus sign, generalized ligamentous hyperlaxity, and apprehension with extreme ranges of motion but no history of acute dislocation. What is the mainstay of initial treatment?

A 21-year-old collegiate athlete is evaluated for recurrent anterior shoulder instability. MRI reveals a Hill-Sachs lesion that is determined to be "off-track". What is the primary clinical significance of an "off-track" lesion in surgical planning?

A 48-year-old man sustains an acute, traumatic anterior shoulder dislocation. After successful closed reduction in the emergency department, he is noted to have persistent, profound weakness in active forward elevation and external rotation, though axillary nerve sensation is intact. What is the most likely diagnosis?

A 22-year-old competitive rugby player presents with his fourth anterior shoulder dislocation. Advanced imaging demonstrates a 26% anterior glenoid bone loss. Which of the following is the most appropriate surgical management to minimize the risk of recurrence?

A 55-year-old man presents with anterior shoulder pain after a fall. Physical examination reveals a positive belly-press test and negative lift-off test. Passive range of motion testing is most likely to reveal which of the following compared to the contralateral normal shoulder?

During arthroscopy for a 45-year-old overhead athlete, you identify a partial articular-sided supraspinatus tendon avulsion (PASTA) lesion. Measurement with a probe indicates the footprint exposed is 8 mm medial-to-lateral. What is the most widely accepted surgical approach for this specific lesion size?

A 28-year-old weightlifter presents with chronic, vague posterior shoulder pain. Examination demonstrates normal forward elevation, normal strength in internal rotation, and symmetric active external rotation in adduction. However, he has marked weakness in external rotation when the arm is abducted to 90 degrees. MRI demonstrates a paralabral cyst. At what anatomic location is this cyst most likely compressing the nerve?

A 24-year-old female presents with recurrent anterior shoulder instability. Arthroscopy reveals an engaging Hill-Sachs lesion. Which of the following best describes the biomechanics of an engaging Hill-Sachs lesion?

During an arthroscopic stabilization for anterior shoulder instability, the surgeon notes an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion. How does this differ anatomically from a classic Bankart lesion?

A 68-year-old man presents with a massive, retracted rotator cuff tear. On physical examination, he is unable to maintain his arm in external rotation against gravity when the arm is supported in 90 degrees of abduction, causing his hand to drop to his mouth when attempting to blow a horn. This "Hornblower's sign" is most indicative of severe fatty infiltration in which of the following muscles?

During the open Latarjet procedure, the coracoid process is transferred to the anterior glenoid neck. Which of the following correctly describes the handling of the subscapularis muscle to allow exposure and transfer of the bone block?

A 19-year-old female gymnast presents with bilateral shoulder pain and a sensation of slipping with overhead activities. Examination reveals positive sulcus signs bilaterally, positive apprehension and relocation tests, and generalized ligamentous laxity.

What is the initial treatment of choice for this condition?

Biomechanically, active shoulder elevation can be maintained in the setting of a massive supraspinatus tear if the "transverse force couple" remains intact. Which two muscles primarily comprise this critical transverse force couple?

A 32-year-old male is evaluated for a locked posterior shoulder dislocation following a generalized seizure. CT imaging reveals an anteromedial humeral head impression defect (reverse Hill-Sachs lesion) involving 25% of the articular surface. Which of the following is the most appropriate surgical intervention?

Following rotator cuff repair, tendon-to-bone healing progresses through distinct biological phases. During the early proliferative phase (1 to 3 weeks post-repair), which type of collagen is predominantly synthesized to form the initial scar tissue matrix?

A 22-year-old rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals a 25% anterior glenoid bone loss. What is the most appropriate surgical treatment?

A 55-year-old manual laborer presents with a chronic, massive, irreparable posterosuperior rotator cuff tear. He has severe weakness in external rotation and active elevation, but subscapularis function remains intact. He has minimal glenohumeral osteoarthritis. Which of the following is the most appropriate tendon transfer?

A 45-year-old man presents with anterior shoulder pain and weakness after falling onto an outstretched arm. Physical examination reveals a positive bear-hug test and increased passive external rotation of the shoulder. Which structure is most likely injured?

A 28-year-old man undergoes magnetic resonance arthrography (MRA) for recurrent anterior shoulder instability. The radiologist notes a 'J-sign' on the coronal fluid-sensitive sequences, representing a capsuloligamentous injury. What specific lesion does this finding describe?