5. Sports Medicine MCQs

A 22-year-old rugby player has recurrent anterior shoulder instability. A CT scan with 3D reconstruction demonstrates 28% glenoid bone loss. What is the most appropriate definitive management?

A 24-year-old professional baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. Examination shows 15 degrees of internal rotation and 130 degrees of external rotation. What is the most likely pathophysiologic mechanism of his shoulder pain?

A 55-year-old man presents with anterior shoulder pain and weakness after a fall onto an outstretched hand. On examination, he has increased passive external rotation. Which of the following physical examination tests would most likely be positive?

A 20-year-old collegiate gymnast complains of deep shoulder pain and mechanical catching. MR arthrogram demonstrates a detachment of the superior labrum and biceps anchor from the glenoid. Which of the following is the most appropriate surgical intervention?

A 25-year-old man sustains an anterior shoulder dislocation during a seizure. Following closed reduction, he is noted to have numbness over the lateral aspect of the shoulder. Which muscle's function is most likely impaired?

A 65-year-old manual laborer undergoes arthroscopy for a partial, fraying tear of the long head of the biceps tendon involving 60% of its substance. He expresses a strong desire to avoid cosmetic deformity and cramping. What is the most appropriate management?

A 35-year-old man presents with a locked posterior shoulder dislocation after a seizure. CT reveals an anteromedial humeral head defect (reverse Hill-Sachs lesion) involving 35% of the articular surface. The patient is active and desires to return to manual labor. What is the most appropriate surgical management?

A 22-year-old collegiate baseball pitcher presents with vague, deep shoulder pain and decreased throwing velocity. MRI arthrogram reveals a Type II SLAP tear. During arthroscopy, what biomechanical mechanism is most commonly observed to exacerbate the pathology when the arm is placed in the late cocking phase of throwing?

A 29-year-old elite volleyball player complains of vague posterior shoulder pain and progressive weakness. Physical examination reveals isolated weakness in external rotation with the arm at the side. Forward elevation and internal rotation strength are normal. MRI demonstrates a paralabral cyst. Where is the cyst most likely located?

A 21-year-old man undergoes a Latarjet procedure for recurrent anterior shoulder instability with 30% glenoid bone loss. The stabilizing "sling effect" provided by this procedure is primarily dependent on the dynamic tension of which structure?

A 34-year-old recreational weightlifter complains of vague, poorly localized posterior shoulder pain and numbness over the lateral deltoid. MRI demonstrates isolated atrophy of the teres minor. The affected nerve is compressed in a space bordered by which of the following structures?

A 42-year-old man presents with a 3-week history of severe, unrelenting shoulder pain that woke him from sleep. The pain has now begun to subside, but he has noticed profound weakness in overhead elevation and external rotation. MRI of the shoulder reveals no rotator cuff tear. EMG confirms acute denervation of the supraspinatus, infraspinatus, and deltoid. What is the most likely diagnosis?

During pre-operative planning for a recurrent anterior shoulder instability patient, a 3D CT scan is obtained. The surgeon uses the 'best-fit circle' method on the sagittal en face view to calculate glenoid bone loss. At what threshold of anterior glenoid bone loss is an arthroscopic Bankart repair generally considered to have an unacceptably high failure rate, making a bone block procedure (e.g., Latarjet) the standard recommendation?

A 24-year-old professional rugby player has a history of recurrent anterior shoulder instability. A 3D CT scan demonstrates 28% anterior glenoid bone loss. He is planned for a Latarjet procedure. Which of the following describes the primary stabilizing mechanism of this procedure when the arm is in the abduction-external rotation (ABER) position?

A 28-year-old professional volleyball player presents with insidious onset of vague posterior right shoulder pain and weakness. Physical examination demonstrates isolated weakness in external rotation with the arm at the side, but forward elevation and abduction strength are completely normal. An MRI is most likely to show a paralabral cyst in which of the following anatomic locations?

A 24-year-old rugby player presents with recurrent anterior shoulder instability. A 3D CT scan reveals 27% anterior glenoid bone loss. What is the most appropriate definitive management?

A 50-year-old man falls on an outstretched arm and experiences acute anterior shoulder pain. Physical examination reveals significantly increased passive external rotation compared to the contralateral side. Which of the following tests is most likely to be positive?

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

A 21-year-old collegiate tennis player complains of posterior shoulder pain during the late cocking phase of his serve. Arthroscopy reveals undersurface fraying of the posterior supraspinatus and anterior infraspinatus, along with corresponding posterosuperior labral fraying. This triad is characteristic of: