5. Sports Medicine MCQs

Following a traumatic anterior shoulder dislocation, a 45-year-old man reports persistent anterior shoulder pain and significant weakness when trying to tuck his shirt into his pants behind his back. Which of the following physical examination tests is most sensitive and specific for evaluating the suspected torn structure?

A 25-year-old recreational athlete presents with recurrent anterior shoulder instability. A 3D CT scan shows 12% anterior glenoid bone loss and a large, engaging Hill-Sachs lesion. Which of the following surgical procedures is most appropriate to address both pathologies?

A 21-year-old elite collegiate baseball pitcher presents with pain in the posterior aspect of his throwing shoulder during the late cocking phase of throwing. He has glenohumeral internal rotation deficit (GIRD) of 25 degrees compared to his non-throwing arm. What is the most likely associated arthroscopic finding?

The normal direct tendon insertion of the rotator cuff onto the greater tuberosity is divided into four distinct histological zones. Which structure marks the boundary between uncalcified fibrocartilage and calcified fibrocartilage?

A 40-year-old man presents with anterior shoulder pain that worsens with cross-body adduction and internal rotation. Examination demonstrates focal tenderness over the coracoid process. MRI reveals a narrowed coracohumeral interval of 4 mm and edema in the lesser tuberosity. Which tendon is most at risk of attritional tearing in this syndrome?

A 75-year-old woman has advanced rotator cuff tear arthropathy. Radiographs reveal superior migration of the humeral head with articulation against the acromion (acetabularization).

What biomechanical alteration is the primary driver of this superior head migration?

During an open repair of a massive, chronically retracted rotator cuff tear, the surgeon performs aggressive lateral mobilization of the supraspinatus tendon. Postoperatively, the patient is noted to have a new, isolated profound weakness in external rotation, with intact forward elevation. Injury to which structure most likely occurred during mobilization?

A 22-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan demonstrates 25% anterior glenoid bone loss. Which of the following is the most appropriate surgical management?

A 35-year-old overhead athlete complains of vague posterior shoulder pain and weakness. Physical examination reveals normal active forward elevation and abduction, but notable weakness in external rotation with the arm at the side. An MRI arthrogram reveals a paralabral cyst. Where is the cyst most likely located?

A 45-year-old construction worker presents with chronic, deep shoulder pain. MRI confirms an isolated Type II SLAP (Superior Labrum Anterior and Posterior) tear. Conservative management has failed. Which of the following surgical interventions is associated with the most reliable return to work and pain relief in this patient demographic?

A 65-year-old man is incidentally found to have an asymptomatic, 1.5 cm full-thickness supraspinatus tear on an MRI obtained for a suspected neck issue. He has full range of motion and 5/5 strength. What is the most accurate information regarding the natural history of his rotator cuff tear?

A 19-year-old collegiate rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 28% anterior glenoid bone loss. Which of the following is the most appropriate definitive management?

A 55-year-old woman is evaluated for right shoulder pain and weakness after a fall. On examination, she has increased passive external rotation compared to the contralateral side. The "belly-press" test is positive, but the "lift-off" test is negative. Which of the following statements best describes her pathology?

A 35-year-old man presents to the emergency department after a generalized tonic-clonic seizure. His arm is locked in internal rotation. Radiographs reveal a posterior shoulder dislocation. CT scan shows an anteromedial humeral head impression fracture (reverse Hill-Sachs lesion) involving 45% of the articular surface. What is the most appropriate surgical treatment?

A 17-year-old female gymnast complains of bilateral shoulder pain and a feeling of the shoulders "sliding out of place." Examination shows a positive sulcus sign bilaterally, positive apprehension, and generalized ligamentous laxity. There is no history of a discrete traumatic dislocation. What is the most appropriate initial management?

During a Latarjet procedure for recurrent anterior shoulder instability, the conjoined tendon is retracted medially to expose the subscapularis. Which of the following nerves is at greatest risk of injury with overly aggressive medial retraction of the conjoined tendon?

A 28-year-old elite volleyball attacker presents with vague posterior shoulder pain and noticeable atrophy over the scapula. On examination, she has 5/5 strength in forward elevation but isolated 3/5 strength in external rotation with the arm at the side. What is the most likely pathological finding on MRI?

A 22-year-old rugby player presents with recurrent anterior shoulder instability. A 3D-CT scan demonstrates 28% anterior glenoid bone loss. Which of the following is the most appropriate surgical management?

A 45-year-old man falls on an outstretched hand and presents with weakness in internal rotation and a positive belly-press test. Which of the following structures is most commonly injured concomitantly with the suspected tendon tear?

A 35-year-old man presents to the emergency department locked in internal rotation after a generalized tonic-clonic seizure. Radiographs confirm a posterior shoulder dislocation. CT scan shows a reverse Hill-Sachs lesion involving 35% of the articular surface. Which of the following is the most appropriate treatment?