5. Sports Medicine MCQs

A 55-year-old manual laborer presents with an irreparable posterosuperior rotator cuff tear. He has significant external rotation weakness and a positive hornblower's sign, but intact forward elevation (pseudoparesis of external rotation). The subscapularis is intact. Which of the following is the most appropriate tendon transfer for this patient?

A 40-year-old male presents with acute, severe, unremitting right shoulder pain lasting for 3 weeks, which has recently begun to subside. However, he now notices profound weakness in lifting his arm. Exam shows atrophy of the deltoid and supraspinatus. MRI of the shoulder is unremarkable. EMG shows denervation in the axillary and suprascapular nerve distributions. What is the most likely diagnosis?

A 45-year-old man falls onto his outstretched hand and presents with anterior shoulder pain. He has increased passive external rotation compared to the contralateral side. The surgeon suspects an acute subscapularis tendon rupture. Which of the following physical examination tests is considered the most sensitive for detecting a partial tear of the upper subscapularis?

A 24-year-old rugby player presents with recurrent anterior shoulder instability. CT scan reveals 25% anterior glenoid bone loss and an engaging Hill-Sachs lesion. Which of the following procedures is most appropriate?

A 28-year-old volleyball player presents with insidious onset of posterior shoulder pain and isolated weakness in external rotation. An MRI is obtained, demonstrating a paralabral cyst.

Based on the clinical presentation, where is the cyst most likely located and what labral pathology is associated with it?

A 55-year-old construction worker presents with insidious onset anterior shoulder pain, positive O'Brien's test, and MRI demonstrating a Type II SLAP tear. There is no significant rotator cuff tearing. What is the most reliable surgical intervention for this patient if conservative management fails?

A 23-year-old professional baseball pitcher presents with pain in the late cocking phase of throwing. MRI arthrogram reveals a partial articular-sided tear of the supraspinatus and fraying of the posterior superior labrum. What is the underlying pathophysiologic mechanism of this injury?

A 38-year-old laborer presents with an irreparable subscapularis tendon tear after a massive anterior shoulder injury. He has persistent pain and weakness in internal rotation. To restore internal rotation strength and dynamic anterior stability, a pectoralis major transfer is planned. To optimize the vector of pull, the transfer is typically routed:

A 22-year-old collegiate baseball pitcher presents with posterior shoulder pain during the late cocking phase of throwing. MRI arthrogram reveals a peel-back lesion of the superior labrum. Which physical exam finding is most closely associated with this specific pathology?

A 26-year-old male sustains an acute, traumatic anterior shoulder dislocation. After successful closed reduction in the emergency department, he notes persistent numbness over the lateral aspect of his shoulder. Which muscle's function is most likely to be impaired?

A 30-year-old male volleyball player presents with isolated weakness in external rotation of his dominant shoulder. Forward elevation and internal rotation strength are normal. MRI reveals a paralabral cyst. At what anatomical location is this cyst most likely compressing the affected nerve?

Latissimus dorsi tendon transfer is occasionally considered for patients with massive, irreparable posterosuperior rotator cuff tears. Which of the following is generally considered an absolute contraindication for this procedure?

Figure 51 demonstrates a physical exam finding in a 55-year-old male laborer complaining of acute, sharp anterior shoulder pain and bruising after lifting heavy equipment. A noticeable 'Popeye' deformity is present. He is highly active and reports severe persistent cramping in the arm. What is the most appropriate definitive management?

A 21-year-old collegiate linebacker undergoes arthroscopic stabilization for recurrent anterior shoulder instability. During diagnostic arthroscopy, the surgeon notes an avulsion of the anteroinferior capsulolabral complex from the glenoid rim. What is the classic eponym for this lesion?

Which of the following bone graft substitutes possesses osteoconductive, osteoinductive, and osteogenic properties?

A 30-year-old patient presents with knee instability. The dial test demonstrates increased external rotation at 30 degrees of knee flexion compared to the contralateral side, but symmetric rotation at 90 degrees. Which structure(s) are isolatedly injured?

An MRI of the shoulder reveals a paralabral cyst compressing the suprascapular nerve strictly at the spinoglenoid notch. Which physical exam finding is most likely to be isolated in this patient?

A 24-year-old athlete is evaluated for exertional compartment syndrome of the lower leg. Manometry of the deep posterior compartment is performed. Which of the following structures is NOT located within this specific compartment?

During a surgical reconstruction of the posterolateral corner of the knee, the surgeon isolates the fibular collateral ligament. This structure attaches to the fibular head in close proximity to which of the following tendons?