6. Spine MCQs

A 22-year-old collegiate baseball pitcher presents with medial elbow pain. The moving valgus stress test is positive. MRI shows a full-thickness tear of the ulnar collateral ligament (UCL). What is the primary restraint to valgus stress at 90 degrees of elbow flexion?

A 16-year-old gymnast presents with chronic low back pain exacerbated by extension. Radiographs are normal, but an MRI shows bone marrow edema in the L5 pars interarticularis without a clear fracture line. What is the most appropriate initial management?

During the throwing motion, which bundle of the ulnar collateral ligament (UCL) of the elbow is the primary restraint to valgus stress from 30 to 120 degrees of flexion?

During the acceleration phase of a baseball pitch, significant valgus stress is placed on the elbow. Which structure provides the primary restraint to valgus stress at 90 degrees of elbow flexion?

Which type of scoliosis is most common in adolescents?

Which of the following is most indicative of a disc herniation with nerve root compression?

Which of the following is an indication for surgical intervention in scoliosis?

Which structure provides the primary restraint to valgus stress at the elbow during the late cocking and early acceleration phases of throwing?

Which of the following best describes the anatomical origin of the reflected head of the rectus femoris, which may be avulsed in a kicking athlete?

A 19-year-old soccer player experiences a sudden pop in his anterior pelvis while kicking. MRI confirms an isolated avulsion of the direct head of the rectus femoris. What is the specific anatomical origin of this tendon?

A 40-year-old former sprinter presents with chronic, deep buttock pain radiating down the posterior thigh, exacerbated by sitting. He has a history of a remote hamstring strain. Examination reveals a positive seated slump test and localized tenderness at the ischial tuberosity. What is the likely diagnosis?

A 15-year-old gymnast presents with acute anterior pelvic pain after performing a split leap. Radiographs reveal an avulsion fracture of the anterior superior iliac spine (ASIS). Which muscle is responsible for this avulsion?

A 16-year-old gymnast experiences a sudden 'pop' over her right anterior pelvis while performing a split jump. She has localized tenderness over the anterior superior iliac spine (ASIS). Which structure is injured?

A 16-year-old soccer player experiences a sudden pop and sharp pain in his anterior pelvis while kicking a ball. Radiographs reveal a bony avulsion fragment displaced 1 cm inferiorly from the anterior inferior iliac spine (AIIS). Which muscle is responsible for this avulsion?

A 32-year-old runner presents with deep gluteal pain radiating down the posterior thigh. Pain is reproduced with resisted external rotation of the hip. MRI of the lumbar spine is normal. The affected nerve passes through the greater sciatic foramen typically in what relation to the piriformis muscle?

A 21-year-old collegiate baseball pitcher presents with medial elbow pain and decreased pitching velocity. Magnetic resonance arthrography demonstrates a tear of the medial ulnar collateral ligament (MUCL). Which structure is the primary restraint to valgus stress between 30 and 120 degrees of elbow flexion?

A 13-year-old female competitive gymnast has had pain in her lumbar spine and anterior thighs for 9 weeks. It has become significant enough to limit her activities. Radiographs of her lumbar and thoracic spine are normal and iliac crests show that she is not skeletally mature. Physical examination is essentially normal with no long tract or nerve tension signs present. What is the next appropriate step in a diagnostic work up:

A football player is down and unconscious after making a tackle. He is found lying supine. What initial management should be undertaken on the playing field:

A 45-year-old male presents with severe lower back pain, bilateral lower extremity weakness, and saddle anesthesia after lifting a heavy box. Which of the following is the most consistent and sensitive early clinical finding of cauda equina syndrome?

A 14-year-old male with an L5-S1 isthmic spondylolisthesis presents with persistent low back pain. Which of the following radiographic parameters is most highly associated with the risk of slip progression?