5. Sports Medicine MCQs

A 55-year-old man presents with profound weakness in active internal rotation after a traumatic lifting injury. MRI confirms an isolated, full-thickness, retracted tear of the subscapularis tendon. Which of the following physical examination findings is most specific for this condition?

A 22-year-old collegiate rugby player experiences recurrent anterior shoulder instability. A pre-operative 3D CT scan reveals 27% anterior glenoid bone loss with an "inverted pear" appearance. What is the most appropriate definitive management?

A 40-year-old man sustains a severe proximal humerus fracture and presents with decreased sensation over the lateral aspect of his shoulder. Assuming the nerve supplying this area is injured, which of the following muscles is most likely to exhibit denervation weakness?

A 28-year-old overhead athlete is diagnosed with a Type II SLAP (Superior Labrum Anterior and Posterior) tear on MR arthrogram. Which of the following best describes the anatomic pathology of a Type II SLAP lesion?

An MRI of a 45-year-old recreational tennis player reveals a partial articular-sided supraspinatus tendon avulsion (PASTA lesion). The tear is estimated to involve 65% of the tendon footprint thickness. Nonoperative management has failed. What is the most appropriate surgical intervention?

A 25-year-old man undergoes an arthroscopic anterior stabilization procedure. Intraoperatively, an engaging Hill-Sachs lesion is identified, and the surgeon decides to perform an arthroscopic remplissage. This procedure involves securing which of the following structures into the humeral head defect?

A 21-year-old collegiate baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. Physical examination reveals a positive apprehension test, but pain is completely relieved with the relocation test. MR arthrogram demonstrates posterior/superior labral fraying and a partial articular-sided supraspinatus tear. What is the most likely diagnosis?

A 19-year-old female competitive swimmer presents with bilateral shoulder pain and a sensation that her shoulders "slide out of place." Examination shows generalized hyperlaxity, a positive sulcus sign that does not reduce with external rotation, and normal rotator cuff strength. What is the most appropriate initial management?

A 38-year-old weightlifter presents with vague posterior shoulder pain and isolated weakness in external rotation. Abduction strength is fully preserved. MRI demonstrates a paralabral cyst located strictly within the spinoglenoid notch. Which of the following muscles is most likely selectively denervated?

A 60-year-old male with an irreparable massive rotator cuff tear (supraspinatus and infraspinatus) without advanced glenohumeral arthritis undergoes a superior capsular reconstruction (SCR) using dermal allograft. The primary biomechanical goal of this procedure is to:

During open repair of a massive rotator cuff tear, the surgeon meticulously decorticates the greater tuberosity to enhance biological healing. To fully restore native biomechanics, the healing tissue must eventually replicate the normal enthesis. The native, direct rotator cuff tendon insertion onto the bone consists of how many distinct histological zones?

A 22-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan of the shoulder reveals an anteroinferior glenoid bone loss of 26%. Which of the following is the most appropriate surgical intervention?

A 74-year-old man presents with chronic shoulder pain and inability to actively elevate his arm above 60 degrees. MRI demonstrates a massive, retracted posterosuperior rotator cuff tear with Goutallier stage 4 fatty infiltration of the supraspinatus and infraspinatus. The subscapularis is intact. What is the most appropriate definitive surgical treatment?

A 35-year-old man with a seizure disorder presents with a locked posterior shoulder dislocation. CT scan demonstrates a reverse Hill-Sachs lesion involving 35% of the humeral articular surface. What is the most appropriate surgical management?

During a physical examination of a patient with suspected rotator cuff pathology, the examiner asks the patient to place the palm of their hand on the opposite shoulder with the elbow anterior to the body, and the examiner applies an upward force to the wrist. Which specific structure is primarily being evaluated?

A 24-year-old man with recurrent anterior instability undergoes a preoperative MRI which reveals an "off-track" Hill-Sachs lesion and 10% anterior glenoid bone loss. What is the most appropriate surgical intervention?

Normal tendon-to-bone healing in the rotator cuff footprint is characterized by four distinct histological zones. What is the correct sequence of these zones from the tendon to the bone?

A 45-year-old manual laborer presents with deep shoulder pain and mechanical catching. He has a positive O'Brien test and dynamic labral shear test. MRI arthrogram demonstrates a Type II SLAP tear. After failing 6 months of nonoperative management, what is the most strongly supported surgical recommendation?

A 21-year-old collegiate baseball pitcher complains of posterior shoulder pain during the late cocking phase of throwing. Physical exam reveals a glenohumeral internal rotation deficit (GIRD) of 25 degrees. What is the primary pathoanatomy associated with internal impingement in this athlete?

A 19-year-old female gymnast presents with bilateral multidirectional shoulder instability. She has failed 9 months of dedicated physical therapy emphasizing periscapular stabilization. If surgical intervention is pursued, what is the most historically validated "gold standard" procedure?