5. Sports Medicine MCQs

During hip arthroscopy for FAI, the patient is placed supine with traction applied via a perineal post. Postoperatively, the patient reports numbness over the dorsum of the foot and profound weakness in great toe extension. Which nerve was most likely injured?

A 25-year-old athlete presents with anterior groin pain exacerbated by hip flexion and internal rotation. AP pelvis radiograph shows a pistol grip deformity. During hip arthroscopy, an osteochondroplasty is performed. To minimize the risk of iatrogenic femoral neck fracture, the resection depth should not exceed what percentage of the femoral neck diameter?

Which of the following radiographic parameters is most characteristic of Pincer-type femoroacetabular impingement (FAI)?

A 24-year-old rugby player has recurrent anterior shoulder instability. CT shows 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. What is the most appropriate surgical treatment?

A 55-year-old man presents with anterior shoulder pain and weakness following a fall. Physical examination reveals increased passive external rotation compared to the contralateral side, and a positive belly-press test. Which tendon is most likely injured?

A 28-year-old volleyball player complains of vague posterior shoulder pain and weakness. Exam reveals isolated atrophy of the infraspinatus with preserved supraspinatus muscle bulk. Where is the most likely site of nerve compression?

A 22-year-old baseball pitcher has posterior shoulder pain during the late cocking phase of throwing. He has a loss of internal rotation (GIRD) of 25 degrees. MRI shows articular-sided partial-thickness tearing of the posterior supraspinatus. What is the most likely diagnosis?

A 20-year-old male baseball pitcher sustains a Type II SLAP tear. Nonoperative management fails. What is the most appropriate next step in management to allow return to his previous level of play?

A 65-year-old man who underwent anatomic total shoulder arthroplasty 5 years ago presents with progressively worsening shoulder pain.

The "rocking horse" phenomenon in anatomic total shoulder arthroplasty, which leads to glenoid loosening, is most directly caused by:

A 42-year-old man suddenly developed excruciating, unprovoked right shoulder pain 2 weeks ago that lasted for several days. As the pain subsided, he noted profound weakness in shoulder abduction and external rotation. EMG shows active denervation of the supraspinatus and deltoid. What is the most likely diagnosis?

A 40-year-old man presents with a locked posterior shoulder dislocation following a seizure. Advanced imaging demonstrates an anteromedial humeral head defect (reverse Hill-Sachs lesion) involving 40% of the articular surface. The glenoid is intact. What is the most appropriate surgical management?

A 30-year-old male volleyball player presents with painless weakness in external rotation of his dominant shoulder. Abduction strength is normal. An MRI confirms a paralabral cyst in the spinoglenoid notch. Which of the following associated pathologies is most likely the root cause of this cyst?

During the evaluation of a patient with a suspected rotator cuff tear, which of the following isolated physical examination findings is most specific for a complete tear of the subscapularis tendon?

A 24-year-old rugby player undergoes an open Latarjet procedure for recurrent anterior shoulder instability associated with 25% glenoid bone loss. Postoperatively, he exhibits profound weakness in elbow flexion and decreased sensation over the lateral aspect of the forearm. Which nerve was most likely injured during the coracoid transfer?

The rotator interval is a critical anatomic space in the shoulder that is often targeted in capsular release or plication. Which of the following structures are contained within this interval?

A 24-year-old baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. He has a 20-degree loss of internal rotation compared to the contralateral side. MRI shows articular-sided partial tearing of the posterior supraspinatus and posterosuperior labral fraying.

What is the primary underlying pathophysiology?

A 35-year-old male presents with recurrent anterior shoulder instability. A CT scan with 3D reconstruction demonstrates 25% anterior glenoid bone loss.

Which of the following procedures is most appropriate?

A 42-year-old construction worker sustained an electrical shock and was diagnosed with a locked posterior shoulder dislocation. CT scan shows an anteromedial humeral head impaction fracture (reverse Hill-Sachs lesion) involving 30% of the articular surface.

The duration of dislocation is 2 weeks. What is the recommended treatment?

A 55-year-old male complains of poorly localized right shoulder pain and weakness, predominantly when externally rotating his arm. Examination reveals isolated atrophy of the infraspinatus with weakness in external rotation. Supraspinatus strength is normal.

MRI is most likely to show:

A 28-year-old volleyball player presents with insidious onset of posterior shoulder pain and weakness. Examination reveals isolated atrophy of the infraspinatus with normal supraspinatus strength. An MRI shows a paralabral cyst. Where is the cyst most likely located?