9. Shoulder and Elbow MCQs

A 50-year-old female with poorly controlled Type 1 Diabetes Mellitus presents with insidious onset of profound, painful restriction of both active and passive shoulder motion. She is diagnosed with the 'freezing' phase of adhesive capsulitis. Which of the following cytokine profiles and histologic findings are most characteristic of the primary pathology in this condition?

A 24-year-old collegiate swimmer presents with a chronic, painful 'clunking' and grinding sensation at the superomedial border of her right scapula during active shoulder elevation. A fluoroscopic guided injection provides temporary relief, but conservative management with periscapular strengthening has ultimately failed. If surgical intervention is pursued, which procedure is most commonly indicated?

A 28-year-old male sustains a high-energy fall, resulting in a highly comminuted, unsalvageable radial head fracture, acute wrist pain with dorsal prominence of the distal ulna, and tearing of the interosseous membrane. Which of the following treatments for the radial head is strictly contraindicated in this specific injury pattern?

A 35-year-old male sustains a terrible triad elbow injury. Intraoperatively, after rigid fixation of the coronoid and radial head, and repair of the lateral ulnar collateral ligament (LUCL), the elbow remains unstable in extension. According to the standard surgical protocol, what is the next best step in management?

A 68-year-old female is 3 years post-operative from a reverse total shoulder arthroplasty. Radiographs reveal scapular notching extending beyond the inferior screw of the glenoid baseplate, but not reaching the central peg. What grade is this according to the Sirveaux classification?

A 28-year-old male weightlifter feels a 'pop' in his anterior chest wall while performing a bench press. Examination reveals ecchymosis and loss of the anterior axillary fold contour. MRI confirms a complete rupture at the sternal head insertion. Which specific motion will exhibit the most significant weakness?

A 32-year-old female presents with shoulder pain and a deformity of her scapula following a posterior triangle lymph node biopsy. On examination, the scapula is translated laterally and superiorly, with prominent winging that worsens with active shoulder abduction. Injury to which nerve is the most likely cause?

A 28-year-old female presents with recurrent elbow clicking and a sense of instability when pushing herself up from a chair. A pivot-shift test of the elbow produces subluxation and apprehension. This condition is primarily caused by insufficiency of which anatomic structure?

A 40-year-old bodybuilder undergoes a single-incision anterior approach for the repair of a distal biceps tendon rupture. Postoperatively, he complains of numbness and tingling along the radial border of his forearm. Which of the following nerves is most likely injured?

A 72-year-old male with long-standing pseudoparalysis of the right shoulder is evaluated for a massive, irreparable rotator cuff tear. MRI reveals Goutallier grade 4 fatty infiltration of the supraspinatus, infraspinatus, and teres minor. He has a positive Hornblower's sign. Which surgical option is most appropriate?

A 30-year-old female presents with shoulder pain and an inability to abduct her arm beyond 90 degrees after undergoing a lymph node biopsy in the posterior triangle of the neck. On exam, she has lateral winging of the scapula. Which nerve was most likely injured?

A 55-year-old male undergoes a radial head excision for an unrepairable radial head fracture. Three months later, he develops severe wrist pain and proximal migration of the radius. Injury to which of the following structures is the primary cause of this complication?

Following a traumatic posterolateral elbow dislocation, a 40-year-old patient complains of a clicking sensation and instability when pushing off from a chair. The primary anatomical structure responsible for preventing this specific instability is the:

A 21-year-old collegiate baseball pitcher presents with posterior elbow pain during the deceleration phase of throwing. He reports a loss of terminal extension. Radiographs are most likely to show osteophyte formation in which location?

A 52-year-old diabetic female presents with an insidious onset of shoulder pain and stiffness over 6 months. She is diagnosed with adhesive capsulitis. Which plane of motion typically demonstrates the earliest and most severe loss in this condition?

A 78-year-old female with osteoporosis sustains a severely comminuted 4-part proximal humerus fracture with head-splitting. Which of the following is the primary biomechanical advantage of treating this with a reverse total shoulder arthroplasty (RTSA) rather than a hemiarthroplasty?

During surgical release for recalcitrant lateral epicondylitis, the pathologic tissue is identified deep to the extensor aponeurosis. Histologic evaluation of this tissue typically reveals angiofibroblastic hyperplasia. Which specific tendinous structure is primarily involved?

A 35-year-old male presents with elbow instability following a sprain. On examination, he has a positive lateral pivot-shift test. Which structure is primarily responsible for preventing posterolateral rotatory instability (PLRI) of the elbow?

In planning a reverse total shoulder arthroplasty (rTSA) for a 70-year-old female with advanced rotator cuff tear arthropathy, how does the prosthesis alter the biomechanical center of rotation compared to the native glenohumeral joint?