9. Shoulder and Elbow MCQs

A 45-year-old diabetic female presents with an acute exacerbation of excruciating shoulder pain. Radiographs reveal a large, amorphous calcific deposit in the supraspinatus tendon. During which phase of calcific tendinitis does the patient typically experience the most severe pain?

In a patient undergoing reverse total shoulder arthroplasty (RTSA), which of the following baseplate positioning strategies is most effective in minimizing the risk of postoperative scapular notching?

In a patient undergoing anatomic total shoulder arthroplasty (TSA), failure to correct excessive posterior glenoid retroversion (B2 glenoid) is most likely to result in which of the following mechanisms of failure?

A 55-year-old patient with type 2 diabetes presents with a profound, painful loss of active and passive shoulder external rotation with the arm at the side. In primary adhesive capsulitis, which structures exhibit the most significant fibroblastic proliferation and contracture?

A 20-year-old collegiate baseball pitcher reports medial elbow pain during the late cocking phase of throwing. He is diagnosed with a UCL injury. Which bundle of the ulnar collateral ligament is the primary restraint to valgus stress between 30 and 120 degrees of flexion?

A 42-year-old bodybuilder hears a "pop" in his antecubital fossa while performing heavy deadlifts. He has a reverse Popeye sign and weakness in forearm supination. The distal biceps tendon inserts onto which of the following structures?

During a distal biceps tendon repair, the surgeon must reattach the tendon to its anatomical footprint on the radial tuberosity. In which portion of the radial tuberosity does the distal biceps predominantly insert?

A baseball pitcher undergoes reconstruction of the ulnar collateral ligament (UCL) of the elbow. Which bundle of the UCL is the primary restraint to valgus stress at 90 degrees of elbow flexion?

A 25-year-old male sustains a midshaft humerus fracture and presents with an inability to extend his wrist and fingers. The injured nerve normally pierces the lateral intermuscular septum to enter the anterior compartment of the arm at approximately what distance proximal to the lateral epicondyle?

Following a lymph node biopsy in the posterior triangle of the neck, a patient develops shoulder weakness and lateral scapular winging. Which of the following muscles is primarily affected due to the injured nerve?

A 40-year-old bodybuilder sustains a distal biceps tendon rupture. During surgical repair through a single anterior incision, the surgeon must be mindful of a nerve that crosses the surgical field deep to the brachioradialis. Which nerve is most at risk?

A 55-year-old patient undergoes a modified radical neck dissection for malignancy. Postoperatively, she is unable to actively elevate her arm above 90 degrees and demonstrates lateral winging of the scapula. Which nerve was most likely injured?

A 25-year-old male sustains a traction injury to his brachial plexus. Clinical examination reveals profound weakness in shoulder extension and internal rotation, but intact rhomboid and serratus anterior function. Which of the following cords of the brachial plexus is most likely injured?

A patient exhibits posterolateral rotatory instability (PLRI) of the elbow. Reconstruction of the primary deficient ligament is planned. What is the anatomic insertion of this key stabilizing ligament?

The radiographs of the elbow and lower legs of a patient with chondroectodermal dysplasia demonstrate short and thick tubular bones as seen below. What is the inheritance pattern of this condition?

A 60-year-old man presents with chronic nodular swelling of his elbows and fingers. Radiographs show periarticular punched-out lytic lesions with overhanging edges. Which of the following is the most likely composition of these nodules?

A 12-year-old boy with Osteogenesis Imperfecta Type V presents with progressive loss of forearm pronation and supination. Radiographs reveal calcification of the interosseous membrane and a dislocated radial head. He reports mild pain but significant functional limitation. What is the most appropriate orthopedic management of the radial head dislocation in this specific patient population?

A 48-year-old woman presents with severe, progressive right shoulder swelling and instability over the last 6 months. She reports minimal pain despite significant deformity. Radiographs show extensive bone resorption of the humeral head and glenoid with intra-articular loose bodies.

What is the most appropriate initial management for this specific shoulder pathology?

A 28-year-old male presents with painless swelling and instability of his right shoulder over the past 6 months. Neurological examination reveals a loss of pain and temperature sensation over his shoulders and upper back, with preserved light touch and proprioception.

What is the underlying pathophysiology of his shoulder pathology?