5. Sports Medicine MCQs

A 21-year-old collegiate basketball player complains of acute lateral foot pain after a pivoting maneuver. Radiographs demonstrate a fracture at the base of the fifth metatarsal extending into the fourth-fifth intermetatarsal articulation.

What is the most appropriate management to minimize the risk of nonunion and expedite his return to sports?

A 28-year-old professional football player suffers a forced hyperextension injury to his first MTP joint. Clinical examination reveals profound weakness with active hallux plantarflexion. MRI demonstrates a complete rupture of the plantar plate with 1 cm of proximal retraction of the sesamoids. What is the most appropriate management?

A 22-year-old collegiate basketball player sustains an acute fracture at the metaphyseal-diaphyseal junction of the fifth metatarsal. He wishes to return to play as soon as possible. What is the most appropriate treatment?

Which of the following statements comparing operative and nonoperative management of acute Achilles tendon ruptures using early functional rehabilitation is most accurate?

A 20-year-old running back sustains a hyperextension injury to his first metatarsophalangeal (MTP) joint. MRI demonstrates a complete tear of the plantar plate and sesamoid complex with proximal migration of the sesamoids. What is the recommended treatment?

A 25-year-old male presents with deep ankle pain after a severe inversion injury 6 months ago. MRI reveals a 1.2 cm osteochondral lesion on the anterolateral aspect of the talar dome. The cartilage is intact but there is subchondral edema. What is the most appropriate initial surgical intervention after failed conservative therapy?

A professional American football player sustains a severe hyperextension injury to his great toe. MRI demonstrates a complete rupture of the plantar plate from the base of the proximal phalanx, with dorsal subluxation of the MTP joint. What grade is this injury, and what is the standard recommended treatment for an elite athlete?

A professional American football lineman sustains a severe hyperextension injury to his first metatarsophalangeal (MTP) joint. MRI shows a complete disruption of the plantar plate with 5 mm proximal retraction of the sesamoids. What is the most appropriate management?

A 25-year-old woman complains of deep, aching anterior ankle pain 8 months after a severe ankle sprain. MRI demonstrates an intact lateral ligament complex but reveals a 1.1 cm x 1.1 cm osteochondral lesion on the anterolateral talar dome with no subchondral cyst. What is the most appropriate first-line surgical treatment?

An 18-year-old collegiate football player sustains an acute hyperextension injury to his great toe. MRI confirms a complete tear of the plantar plate at the first metatarsophalangeal joint. What is the most appropriate management for this athlete?

A 20-year-old elite basketball player experiences acute lateral foot pain during practice. Radiographs reveal a fracture at the metaphyseal-diaphyseal junction of the fifth metatarsal.

What is the recommended treatment to minimize the risk of nonunion and allow early return to play?

A professional running back sustains an injury to his great toe during a tackle, resulting in forced hyperextension of the first metatarsophalangeal (MTP) joint. MRI reveals a complete tear of the plantar plate with retraction of the sesamoids. Which of the following is the most appropriate management?

A 32-year-old woman presents with chronic deep ankle pain following an inversion sprain 2 years ago. MRI demonstrates a 12 mm x 10 mm deep osteochondral lesion on the posteromedial aspect of the talar dome. No cystic changes are noted. What is the best initial surgical intervention if conservative management fails?

A 24-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A CT scan reveals 26% anterior glenoid bone loss.

What is the most appropriate definitive management?

A 45-year-old man presents with severe shoulder pain and restricted external rotation following a grand mal seizure. Radiographs confirm a locked posterior shoulder dislocation with a reverse Hill-Sachs lesion involving 35% of the articular surface. Which of the following is the most appropriate surgical treatment?

A 32-year-old competitive volleyball player reports vague posterior shoulder pain and weakness with external rotation. Examination shows isolated atrophy of the infraspinatus. MRI reveals a multiloculated cystic structure at the spinoglenoid notch.

What associated intra-articular pathology is most likely present?

A 75-year-old man presents with chronic right shoulder pain and an inability to actively elevate his arm above 40 degrees. Passive range of motion is full. Radiographs reveal superior migration of the humeral head with an acromiohumeral interval of 3 mm. MRI confirms a massive, retracted tear of the supraspinatus and infraspinatus with Goutallier stage 4 fatty infiltration. His deltoid is functional. What is the most appropriate definitive management?

A 22-year-old collegiate linebacker presents with recurrent anterior shoulder instability. He has had 5 dislocations over the past two seasons. A 3D CT scan reveals 25% anterior glenoid bone loss. What is the most appropriate surgical management?

A 55-year-old man presents with anterior shoulder pain and weakness following a fall while water skiing. On physical examination, he has full passive range of motion. When the patient places the palm of his hand on his opposite shoulder, he is unable to resist the examiner pulling the hand away anteriorly. Which tendon is most likely injured?

A 32-year-old elite volleyball player complains of vague posterior shoulder pain and weakness with external rotation. Examination shows isolated atrophy of the infraspinatus fossa with normal supraspinatus bulk. Which of the following is the most likely etiology?