9. Shoulder and Elbow MCQs

A 58-year-old male weightlifter presents with advanced glenohumeral osteoarthritis. A CT scan reveals a biconcave glenoid with severe retroversion and posterior subluxation of the humeral head. According to the Walch classification, what type of glenoid morphology does this represent?

A patient undergoes surgical repair of an acute distal biceps tendon rupture using a single-incision anterior approach. Postoperatively, he complains of burning pain and numbness along the lateral aspect of his forearm. Which nerve was most likely injured during the surgical exposure?

The anterior bundle of the medial collateral ligament (AMCL) is the primary restraint to valgus instability of the elbow. What is the precise distal insertion site of the AMCL?

A 14-year-old male baseball pitcher presents with lateral elbow pain and catching. Radiographs and MRI demonstrate a detached osteochondral fragment in the capitellum with an underlying fluid signal. What is the most appropriate diagnosis?

During a radial head arthroplasty for a comminuted radial head fracture, the surgeon inadvertently overstuffs the radiocapitellar joint by 4 mm. Which of the following biomechanical consequences is most likely to occur as a direct result of this technical error?

A 35-year-old female presents with shoulder weakness 3 months after a posterior triangle cervical lymph node biopsy. On physical examination, the shoulder exhibits lateral winging of the scapula when she abducts her arm. Injury to which nerve is responsible for this physical finding?

A 45-year-old male laborer presents with acute anterior elbow pain and ecchymosis after attempting to lift a heavy box. Examination reveals a positive hook test. During a single-incision anterior surgical repair using suture anchors, which nerve is at the highest risk of injury?

A 62-year-old male presents with advanced glenohumeral osteoarthritis. CT scan reveals a retroverted biconcave glenoid (Walch B2) with 20 degrees of retroversion. He has an intact rotator cuff. What is the most appropriate surgical management?

A 35-year-old female presents with shoulder pain and weakness 4 weeks after a posterior cervical triangle lymph node biopsy. On examination, the affected shoulder droops, and the scapula rests lateral to the midline and wings when she abducts her arm. Injury to which of the following nerves is the most likely cause?

A 32-year-old female complains of a recurrent clicking and giving way of her elbow when pushing up from a chair. Physical examination demonstrates apprehension with the elbow supinated, axially loaded, and moving from extension into flexion. Which ligamentous structure is primarily deficient?

A 75-year-old female with osteoporosis sustains a 4-part proximal humerus fracture. Radiographs show severe comminution of the calcar and the humeral head split into two fragments. What is the most reliable surgical option to restore active elevation?

A 24-year-old manual worker presents with painful crepitus and snapping at the superomedial border of his scapula. Non-operative management has failed after 6 months. Imaging reveals a skeletal prominence at the superomedial angle. What is the anatomical name of this structure commonly responsible for this syndrome?

A 45-year-old male hears a pop in his anterior elbow while lifting a heavy box. On examination, he has a positive hook test. He undergoes a single-incision distal biceps tendon repair. Postoperatively, he complains of numbness along the lateral aspect of his forearm. Which structure was most likely injured during the surgical exposure?

A 30-year-old male presents with lateral elbow pain and a clicking sensation when extending and supinating the elbow. He is diagnosed with posterolateral rotatory instability (PLRI) and is scheduled for ligament reconstruction. What are the correct isometric points for reconstructing the primary ligament deficient in this condition?

Reverse total shoulder arthroplasty (rTSA) relies heavily on the deltoid muscle to compensate for a deficient rotator cuff. How does the standard Grammont-style rTSA alter glenohumeral biomechanics to achieve this?

A 22-year-old overhead athlete presents with persistent anterior shoulder apprehension. Magnetic resonance arthrography (MRA) demonstrates a "J sign" with extravasation of contrast into the axillary pouch due to an avulsion of the inferior glenohumeral ligament from the humeral neck. What is the eponymous term for this lesion?

A 35-year-old female falls onto an outstretched hand. A lateral radiograph of the elbow demonstrates a "double arc sign." What specific injury does this radiographic finding indicate?

A 45-year-old tennis player fails 12 months of conservative management for lateral epicondylitis. An open debridement of the extensor carpi radialis brevis (ECRB) is planned. Topographically, where is the ECRB origin located relative to the extensor carpi radialis longus (ECRL)?

A 68-year-old male with severe glenohumeral osteoarthritis undergoes preoperative planning for an anatomic total shoulder arthroplasty. A 3D CT scan reveals a Walch B2 glenoid with 22 degrees of retroversion and significant posterior subluxation. What is the most appropriate intraoperative management of the glenoid?

A 35-year-old male develops medial scapular winging following a prolonged viral illness. Electromyography confirms neuropathy of the affected muscle's primary nerve. Which nerve roots predominantly supply this injured nerve?