5. Sports Medicine MCQs

A 60-year-old male is evaluated for a massive, retracted rotator cuff tear. An MRI reveals Goutallier Stage 4 fatty infiltration of the infraspinatus. How is Goutallier Stage 4 defined on imaging?

During arthroscopic evaluation of a massive rotator cuff tear, the surgeon identifies the 'comma sign'. This anatomical landmark is formed by the avulsion and retraction of which structures?

A 45-year-old overhead athlete presents with persistent shoulder pain. MRI reveals a Partial Articular-Sided Tendon Avulsion (PASTA) of the supraspinatus. At what depth of footprint involvement is surgical completion and repair generally indicated?

A 68-year-old male is 6 weeks status-post anatomic total shoulder arthroplasty via a deltopectoral approach. He complains of sudden anterior shoulder pain and weakness after reaching out for a door. Exam shows a positive belly-press test and increased passive external rotation compared to his immediate postoperative records. What is the most likely complication?

A 48-year-old male presents with shoulder pain. MRI shows a full-thickness supraspinatus tear and a cyst at the spinoglenoid notch. Which physical examination finding is most likely to be present?

During an arthroscopic rotator cuff repair, the surgeon evaluates the footprint of the torn tendons. Which of the following accurately describes the anatomic footprint of the infraspinatus tendon on the greater tuberosity?

A 28-year-old professional volleyball player complains of vague posterior shoulder pain and weakness with external rotation. Examination reveals isolated atrophy of the infraspinatus fossa. An MRI demonstrates a paralabral cyst. At which of the following anatomical locations is the nerve compression most likely occurring?

A 35-year-old overhead athlete undergoes shoulder arthroscopy after failing conservative management for persistent shoulder pain. Diagnostic arthroscopy reveals an articular-sided partial tear of the supraspinatus involving 60% of the tendon thickness. What is the most appropriate management?

A 65-year-old man presents with chronic right shoulder pain and weakness. On physical examination, he has full passive range of motion. When his arm is passively abducted to 90 degrees and externally rotated to 90 degrees, the examiner releases the arm and the patient is unable to maintain the externally rotated position, causing the arm to drop into internal rotation. Which of the following muscles is most likely deficient, and what is its primary innervation?

A 55-year-old manual laborer presents with chronic shoulder pain and weakness. MRI reveals a massive, retracted, and fatty-infiltrated tear of the supraspinatus and infraspinatus. His subscapularis is completely intact. Clinically, he has intact active forward elevation but a positive drop sign and severe external rotation lag. There is no evidence of glenohumeral osteoarthritis. Which of the following surgical procedures is most appropriate to restore his external rotation?

A 48-year-old woman is evaluated for right shoulder pain after a fall. The orthopaedic surgeon asks the patient to place the palm of her right hand on her left shoulder with her elbow pointing forward. The surgeon then attempts to pull the patient's hand off the shoulder while instructing the patient to resist. The patient is unable to keep her hand pressed against the shoulder. This physical examination finding is most indicative of a tear in which of the following structures?

A 30-year-old professional dancer presents with a 5-year history of progressive pain and stiffness in her right great toe, significantly impacting her career. She has failed all conservative measures. Radiographs show moderate dorsal osteophytes, mild joint space narrowing, and a focal osteochondral lesion on the metatarsal head, consistent with Coughlin and Shurnas Grade 2-3. She is highly motivated to preserve motion. Based on the case, which surgical approach, potentially combined with cheilectomy, would be most appropriate for this patient?

A 2-year-old child with fibular hemimelia is being evaluated for lower extremity reconstruction versus amputation. Along with the fibular absence and limb length discrepancy, which of the following knee ligament anomalies is most commonly associated with this condition?

A 2-year-old child presents with a foreshortened leg, absent lateral digits, and an anteromedial bow of the tibia. Which of the following knee anomalies is most universally associated with this patient's underlying diagnosis?

A 68-year-old sedentary male presents with a complete distal biceps tendon rupture sustained 8 weeks prior. He reports mild discomfort but states he can manage most daily activities without significant difficulty, as he primarily uses his left arm for heavier tasks. He has a history of severe coronary artery disease and is on multiple anti-coagulants. MRI confirms a complete rupture with 4 cm of tendon retraction.

Which of the following is the most appropriate initial management strategy for this patient?

A 50-year-old active male presents 6 weeks after sustaining a complete distal biceps tendon rupture. He initially tried conservative management but now desires surgical repair due to persistent weakness impacting his work. MRI shows significant tendon retraction and early muscle atrophy.

What is the most likely implication of this delayed presentation on the surgical repair?

A 45-year-old male presents 6 weeks after an acute distal biceps rupture. Surgical repair is attempted but the tendon is severely retracted and cannot be directly mobilized to the radial tuberosity. Which of the following is the most commonly utilized autograft option for reconstruction?

A 10-year-old girl with an symptomatic calcaneonavicular coalition fails nonoperative management. She undergoes a surgical resection of the coalition. To prevent recurrence, which of the following tissues is most commonly interposed into the resection gap?

A 28-year-old professional basketball player sustains an acute knee injury after an awkward landing. He reports hearing a 'pop' and describes immediate swelling and difficulty bearing weight. Lachman test is positive, and there is a positive pivot shift. What is the most appropriate next step in management?

Which of the following describes the anatomical structure primarily responsible for providing a 'rotary stability' to the knee, especially against external tibial rotation in a valgus stress?