9. Shoulder and Elbow MCQs

When performing a Woodward procedure for a severe Sprengel's deformity, which neurovascular structure is at highest risk during the caudal relocation of the scapula?

A 5-year-old patient has a Sprengel's deformity where the shoulder joint is level with the opposite side, but the deformity is visible when the patient is dressed due to a prominent superomedial angle. According to the Cavendish classification, what grade is this?

During the Woodward procedure for Sprengel's deformity, the origins of specific muscles are detached from the spinous processes to allow inferior mobilization of the scapula. Which nerve is most directly at risk of injury during the mobilization of the trapezius muscle?

During a Woodward procedure for a severe Sprengel's deformity in a 5-year-old child, the scapula is mobilized and displaced inferiorly to improve cosmesis and shoulder function. Postoperatively, the child demonstrates weakness in elbow flexion and altered sensation over the lateral forearm. Which structure was most likely stretched during the scapular lowering?

A 5-year-old girl sustains a minimally displaced lateral condyle fracture of the humerus that is treated nonoperatively. She is lost to follow-up and presents 15 years later with progressive numbness and tingling in her ring and small fingers. What is the most likely underlying cause of her current symptoms?

A 48-year-old man presents with right shoulder pain worsened by overhead activity. Radiographs reveal an incidental 3 cm medullary lesion with stippled calcifications in the proximal humerus without cortical scalloping. A subacromial corticosteroid injection provides 100% relief of his shoulder pain. What is the next best step in management of the bone lesion?

A 28-year-old man sustained a severe closed head injury and an elbow dislocation. After 1 month, he has pain and stiffness, with the radiograph shown. Management includes open reduction, heterotopic bone excision, and capsular releases. What is the primary role of the dynamic hinged fixator in this setting?

A 28-year-old man presents with a chronic elbow dislocation and heterotopic ossification following a severe head injury, as shown in the radiograph. He is scheduled for open reduction, heterotopic bone excision, and capsular releases. What is the primary biomechanical purpose of applying a dynamic hinged elbow fixator in this setting?

The provided arthroscopic view of the radiocapitellar joint is obtained from an anterior medial portal. When performing a capsular excision in the midportion of the capitellum, which of the following nerves is at greatest risk of iatrogenic injury?

A 28-year-old man with a history of severe traumatic brain injury presents with a stiff, painful elbow one month after a closed reduction of an elbow dislocation. Radiographs show extensive heterotopic ossification. What is the primary role of the hinged elbow fixator in the definitive surgical management of this condition?

A 28-year-old man presents with a chronic elbow dislocation and heterotopic ossification following a severe head injury, as seen in the radiograph. He is scheduled for open reduction, heterotopic bone excision, and capsular releases. What is the primary biomechanical purpose of applying a dynamic hinged elbow fixator in this setting?

The arthroscopic view of the elbow shown is taken from an anterior medial portal, visualizing the radiocapitellar joint. When performing a capsular excision in the midportion of the capitellum, which neurovascular structure is at greatest risk of iatrogenic injury?

A 28-year-old man presents with a chronic elbow dislocation and heterotopic ossification following a severe head injury, as shown in the radiograph. He is scheduled for open reduction, heterotopic bone excision, and capsular releases. What is the primary purpose of applying a dynamic hinged elbow fixator in this setting?

A 45-year-old man with a history of recurrent acute podagra and visible tophi on his elbows is started on long-term medical therapy to lower his serum uric acid. He is prescribed a medication that inhibits xanthine oxidase. Which of the following drugs fits this mechanism?

Which joint is most frequently affected by primary synovial chondromatosis?

Which major articulation is overwhelmingly the most common site of involvement for primary synovial chondromatosis?

A 12-year-old boy presents with progressive back pain and bilateral hip pain. Radiographs show mild platyspondyly with a characteristic 'hump-shaped' build-up of bone on the central and posterior portions of the vertebral endplates. His maternal uncle has a similar history of early-onset osteoarthritis. What is the inheritance pattern of this specific skeletal dysplasia?

A 72-year-old male presents with severe shoulder pain, inability to elevate his arm above 45 degrees (pseudoparalysis), and hornblower's sign. Radiographs show superior migration of the humeral head with severe glenohumeral arthritis and acetabularization of the acromion (Hamada Stage IV). What is the optimal surgical management?

A 28-year-old male presents to the emergency department after a motor vehicle collision. He was the restrained driver and his hands were on the steering wheel at the time of impact. He complains of severe left shoulder pain and an inability to move the arm. On examination, his arm is locked in internal rotation. Which of the following positions most commonly predisposes the shoulder to this type of dislocation?