5. Sports Medicine MCQs

Arthroscopy of a 21-year-old male with recurrent anterior shoulder dislocations reveals an anterior labral injury where the labrum and anterior band of the IGHL have avulsed from the glenoid but the underlying periosteum is intact, allowing the labrum to heal medially and inferiorly on the scapular neck. What is the diagnosis?

A 28-year-old professional volleyball player presents with isolated weakness in shoulder external rotation. He has no pain or history of acute trauma. Physical examination reveals normal strength in forward elevation and abduction, but profound weakness in external rotation with the arm at the side. Atrophy is noted in the infraspinatus fossa. Where is the most likely location of nerve entrapment?

A 45-year-old male complains of an acute onset of severe, unprovoked right shoulder pain that woke him from sleep. The pain lasted for 2 weeks and was unresponsive to NSAIDs. As the pain finally subsided, he noticed profound weakness in overhead elevation and external rotation. MRI of the shoulder demonstrates diffuse T2 hyperintensity in the supraspinatus and infraspinatus muscles, with structurally intact tendons. What is the most likely diagnosis?

In a patient with a massive, irreparable posterosuperior rotator cuff tear and an intact subscapularis, a lower trapezius tendon transfer is performed. What is the primary functional goal of this specific transfer?

A 25-year-old male sustains an anterior shoulder dislocation during a wrestling match. Following reduction, an MR arthrogram is obtained, revealing extravasation of contrast inferiorly forming a classic 'J' sign. Which structure has been avulsed?

A surgeon is considering a latissimus dorsi tendon transfer for a 55-year-old laborer with a massive rotator cuff tear. Which of the following concurrent physical examination findings is a widely accepted contraindication to this procedure?

The stability of the long head of the biceps tendon (LHBT) as it enters the bicipital groove is maintained by the biceps pulley. Which three anatomical structures form this essential stabilizing sling?

A 28-year-old weightlifter presents with acute anterior shoulder pain after performing heavy bench presses. Examination reveals bruising over the medial arm, weakness in internal rotation, and loss of the anterior axillary fold contour. MRI confirms a complete pectoralis major tendon rupture. Which specific portion of the muscle-tendon unit is most commonly injured in this mechanism?

A 55-year-old male with a massive, irreparable posterosuperior rotator cuff tear is scheduled for a latissimus dorsi tendon transfer. Which of the following preoperative clinical findings is considered an absolute contraindication for this procedure?

A 65-year-old woman undergoes anatomical total shoulder arthroplasty for primary osteoarthritis. Six weeks postoperatively, she presents with severe anterior shoulder pain, significantly increased passive external rotation compared to her intraoperative baseline, and a positive belly-press test. What is the most likely complication?

A 22-year-old rugby player has recurrent anterior shoulder instability. A 3D CT scan is used to evaluate the 'glenoid track'. An 'off-track' Hill-Sachs lesion is identified. Which of the following strictly defines an off-track lesion?

A 45-year-old male presents with acute posterior shoulder pain and an inability to actively externally rotate his shoulder after a severe electrical shock. Radiographs demonstrate a 'lightbulb sign'. Which associated bony injury dictates the need for a bone grafting procedure rather than a soft tissue transfer (Modified McLaughlin) alone?

A 25-year-old rugby player undergoes a Latarjet procedure for recurrent anterior shoulder instability with 25% glenoid bone loss. During the coracoid transfer, which nerve is at the greatest risk of injury when mobilizing the conjoined tendon?

A 29-year-old overhead athlete presents with vague posterior shoulder pain and numbness over the lateral deltoid. MRI demonstrates isolated atrophy of the teres minor muscle. Entrapment of the axillary nerve in the quadrilateral space is suspected. What are the superior and inferior borders of this space?

A 35-year-old male presents with a locked posterior shoulder dislocation after a seizure. CT scan reveals a reverse Hill-Sachs lesion involving 30% of the humeral head articular surface. Which of the following is the most appropriate surgical management?

A 22-year-old pitcher experiences worsening anterior shoulder pain and a 'dead arm' sensation. Physical exam reveals a positive 'O\'Brien test' and pain on the 'peel-back' mechanism. If a Type II SLAP tear is confirmed, what is the defining characteristic of this lesion?

A 21-year-old collegiate baseball pitcher presents with glenohumeral internal rotation deficit (GIRD) and shoulder pain during the late cocking phase of throwing. What is the primary pathomechanical consequence of an untreated, significantly thickened posterior band of the inferior glenohumeral ligament (IGHL) in this athlete?

A 45-year-old male develops sudden, severe left shoulder pain that lasts for several weeks, followed by profound weakness in shoulder abduction and external rotation. Electromyography (EMG) confirms Parsonage-Turner syndrome (idiopathic brachial neuritis). Which of the following is the most appropriate initial management?

During physical examination of a patient with suspected subscapularis pathology, the examiner performs the 'belly-press test' and the 'lift-off test'. Which specific portion of the subscapularis is maximally tested by the belly-press test?

A 60-year-old male presents with chronic shoulder pain and weakness. MRI shows a massive tear of the supraspinatus and infraspinatus with Grade 4 Goutallier fatty infiltration. Which of the following makes him a poor candidate for a latissimus dorsi tendon transfer?