5. Sports Medicine MCQs

A 22-year-old collegiate offensive lineman presents with recurrent posterior shoulder instability. He has not had any frank dislocations but experiences a "clunking" sensation when pass blocking. Physical examination reveals a positive Jerk test. Radiographs and MRI show no significant bone loss or labral tearing. He wishes to pursue nonoperative management. A physical therapy program should primarily focus on strengthening which of the following muscle groups to provide dynamic stability against posterior humeral head translation?

A 28-year-old weightlifter presents with vague posterior shoulder pain and weakness in external rotation. He has a history of recurrent posterior shoulder subluxations. Physical examination demonstrates atrophy of the infraspinatus fossa but normal bulk of the supraspinatus. MRI reveals a posterior labral tear with an associated paralabral cyst. At which of the following anatomic locations is the cyst most likely compressing the affected nerve?

A 40-year-old man presents with a locked posterior shoulder dislocation following an electrocution injury 3 weeks ago. A CT scan demonstrates an anteromedial humeral head impaction fracture (reverse Hill-Sachs lesion) involving 25% of the articular surface. The glenoid is intact. Which of the following is the most appropriate surgical management?

A surgeon is performing an open posterior approach to the shoulder for a posterior bone block procedure to address recurrent posterior instability. After incising the deltoid in line with its fibers, an internervous plane is utilized to access the posterior joint capsule. This plane is located between which of the following two muscles?

A 20-year-old female gymnast presents with bilateral shoulder pain and a feeling of her shoulders "slipping out of place." She can voluntarily subluxate her shoulders posteriorly. Physical exam reveals a positive sulcus sign of 3 cm bilaterally that does not reduce with external rotation. She has generalized ligamentous laxity with a Beighton score of 7/9. What is the most appropriate initial management for this patient's posterior instability?

A 35-year-old electrician presents to the emergency department after sustaining a high-voltage electrical shock. His right arm is locked in internal rotation and he resists any external rotation. A CT scan confirms a posterior shoulder dislocation. The classic bony defect associated with this injury is located on which aspect of the humerus?

During a physical examination for suspected posterior shoulder instability, the examiner performs the Jerk test. The patient is seated, and the arm is placed in 90 degrees of forward flexion and internal rotation. While applying an axial load to the humerus, the examiner moves the arm in which of the following directions to elicit a clunk?

A 42-year-old male presents with a locked posterior shoulder dislocation following a seizure 3 weeks ago. Imaging reveals a reverse Hill-Sachs defect that involves 30% of the articular surface. He is highly active and wishes to retain his native joint. Which of the following is the most appropriate surgical intervention?

A 24-year-old professional baseball pitcher presents with vague posterior shoulder pain that affects his performance. He denies any frank instability. During which phase of the throwing motion is posterior shoulder instability and capsular stress most commonly symptomatic?

During diagnostic arthroscopy for chronic posterior shoulder pain in a contact athlete, the surgeon identifies a 'Kim lesion'. Which of the following best describes this pathoanatomic finding?

A 27-year-old rugby player presents with recurrent posterior shoulder instability. Advanced imaging reveals a posterior glenoid bone loss of 25%. Soft tissue structures are relatively preserved. What is the most appropriate surgical management to prevent recurrent instability?

On a standard AP radiograph of a patient with a suspected posterior dislocation, a dense vertical line is noted on the medial aspect of the humeral head. This 'trough line' represents which of the following pathologic findings?

The classic (original) McLaughlin procedure, utilized for the treatment of moderate-sized anteromedial humeral head defects, involves the transfer of which of the following structures into the bony defect?

During standard shoulder arthroscopy for a posterior labral tear, the surgeon is establishing the standard posterior viewing portal. What are the correct anatomic landmarks for placing this portal?

A 21-year-old collegiate swimmer with recurrent posterior subluxations has failed 6 months of targeted physical therapy. Diagnostic arthroscopy reveals a severely patulous posterior capsule but a completely intact and well-fixed posterior labrum. What is the most appropriate arthroscopic surgical step?

Bilateral posterior shoulder dislocations are a rare clinical entity but are highly specific to a particular mechanism of injury. Which of the following etiologies is most classically associated with simultaneous bilateral posterior dislocations?

A 32-year-old male sustains a locked posterior shoulder dislocation during a seizure. CT imaging reveals an anteromedial humeral head impaction fracture involving 35% of the articular surface. The glenoid is completely intact. Which of the following is the most appropriate surgical management?

A 21-year-old collegiate rower undergoes shoulder arthroscopy for chronic, painful posterior shoulder instability. The surgeon visualizes an incomplete, concealed avulsion of the posteroinferior labrum. The articular margin remains intact, but there is loss of normal labral height. What is the correct eponym for this specific lesion?

A 26-year-old male volleyball player presents with insidious onset posterior shoulder pain and weakness in external rotation. MRI reveals a posterosuperior labral tear with a multiloculated cyst occupying the spinoglenoid notch. Which of the following physical examination findings is most likely present?