5. Sports Medicine MCQs

A 42-year-old male is brought to the emergency department after a first-time seizure. He holds his right arm locked in internal rotation. Radiographs reveal a posterior shoulder dislocation with an anteromedial humeral head impaction fracture (reverse Hill-Sachs lesion). A subsequent CT scan shows the defect involves 35% of the articular surface. Which of the following is the most appropriate surgical treatment?

A 45-year-old manual laborer presents with deep anterior shoulder pain. Clinical examination reveals a positive O'Brien test and tenderness in the bicipital groove. MRI confirms an isolated type II SLAP tear. After 6 months of failed conservative management, what is the recommended surgical intervention?

A 22-year-old collegiate rugby player has recurrent anterior shoulder instability. CT scan indicates 25% anterior glenoid bone loss. Which of the following is the most appropriate surgical intervention?

A 35-year-old male presents with isolated weakness in external rotation of the shoulder following a severe traction injury. Atrophy of the infraspinatus is noted, but the supraspinatus is clinically and radiographically normal. Where is the most likely site of nerve compression or injury?

A 32-year-old male bodybuilder feels a sudden 'pop' and tearing sensation in his anterior chest wall while performing a heavy bench press. Examination reveals loss of the anterior axillary fold contour and weakness in internal rotation. MRI confirms a complete distal avulsion of the pectoralis major tendon. What is the recommended management?

A 40-year-old man presents with persistent shoulder pain and inability to actively lift his hand off his abdomen (positive belly-press test). MRI demonstrates a complete, retracted subscapularis tear with Goutallier stage 4 fatty infiltration. What is the most appropriate tendon transfer for this patient?

A 65-year-old patient presents with an acute anterior shoulder dislocation after a fall. The joint is successfully reduced. Two weeks later, the patient continues to complain of profound weakness in shoulder abduction and external rotation despite normal radiographs. What is the most likely diagnosis?

Which of the following physical examination findings is most specific for identifying a SLAP (Superior Labrum Anterior to Posterior) tear in a throwing athlete?

A 30-year-old right-hand-dominant male presents with recurrent anterior shoulder instability. An MRI shows an engaging Hill-Sachs lesion without critical glenoid bone loss. Which of the following procedures specifically addresses the engaging nature of this lesion?

A 22-year-old competitive rugby player presents with recurrent anterior shoulder instability. Advanced imaging reveals 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. Which of the following surgical procedures is the most appropriate management to minimize the risk of recurrence?

A 45-year-old heavy laborer presents with profound external rotation weakness and a massive, irreparable posterosuperior rotator cuff tear. Imaging confirms an intact subscapularis and no evidence of glenohumeral osteoarthritis. Which of the following tendon transfers is most appropriate for this patient?

A 35-year-old male presents with his arm locked in internal rotation following a generalized seizure. A CT scan confirms a posterior shoulder dislocation with an anteromedial humeral head defect (reverse Hill-Sachs lesion) involving 30% of the articular surface. What is the most appropriate management?

A 20-year-old male with recurrent anterior shoulder dislocations is found to have 10% glenoid bone loss and a deep, engaging Hill-Sachs lesion on dynamic arthroscopy. Which of the following is the most appropriate arthroscopic management?

A 45-year-old overhead athlete is diagnosed with a symptomatic Type II SLAP tear that has failed conservative management. Compared to an isolated SLAP repair, performing a primary biceps tenodesis in this age group is typically associated with:

A 30-year-old elite volleyball player presents with vague posterior shoulder pain. MRI reveals a large paralabral cyst in the spinoglenoid notch. Which of the following physical examination findings is most specific to this anatomic level of nerve compression?

A 22-year-old collegiate rugby player presents with his fourth anterior shoulder dislocation this season. A 3D CT scan of the shoulder reveals 26% anterior glenoid bone loss. Which of the following is the most appropriate surgical management to minimize his risk of recurrent instability?

A 35-year-old man presents to the emergency department with a locked posterior shoulder dislocation following a seizure. Following closed reduction, a CT scan reveals an anteromedial humeral head impaction fracture (reverse Hill-Sachs lesion) involving 30% of the articular surface. Which of the following is the most appropriate surgical treatment?

A 55-year-old woman is diagnosed with a massive, chronically retracted rotator cuff tear involving the supraspinatus and infraspinatus. She demonstrates profound weakness in external rotation. Electromyography (EMG) reveals denervation of the infraspinatus. What is the most likely mechanism of nerve injury in this setting?

A 19-year-old female gymnast complains of bilateral shoulder pain and a sensation of the shoulders "sliding out of joint." Physical exam demonstrates a positive sulcus sign bilaterally that persists in external rotation, positive apprehension tests, and generalized ligamentous laxity. What is the most appropriate initial management?

A 52-year-old construction worker complains of deep anterior shoulder pain, particularly when using a hammer. Examination reveals a positive O'Brien's active compression test and tenderness in the bicipital groove. MRI arthrogram demonstrates an isolated Type II SLAP tear. Nonoperative management has failed. What is the preferred surgical intervention?