9. Shoulder and Elbow MCQs

A 45-year-old male presents with severe shoulder pain after a motor vehicle accident. The AP shoulder radiograph shows a distance of 8 mm between the anterior glenoid rim and the medial aspect of the humeral head. What is this radiographic sign called, and what diagnosis does it strongly suggest?

During the physical examination of a patient with suspected posterior shoulder instability, the examiner seats the patient, abducts the arm to 90 degrees, and applies an axial load to the elbow while elevating the arm diagonally upward and forward. The patient experiences sudden posterior shoulder pain without a mechanical clunk. Which provocative test was performed?

A biomechanical study is evaluating the capsuloligamentous restraints of the shoulder joint. At 90 degrees of forward flexion and internal rotation, which of the following structures serves as the primary static restraint to posterior humeral head translation?

A 25-year-old weightlifter presents with recurrent posterior shoulder subluxations that have failed extensive physical therapy. Preoperative computed tomography demonstrates excessive glenoid retroversion. Above what threshold of glenoid retroversion is a posterior opening wedge osteotomy or bone block generally indicated over isolated soft tissue stabilization?

A 29-year-old patient sustained a severe elbow trauma and developed heterotopic ossification, resulting in functional ankylosis. Surgical excision is planned. To minimize recurrence, what is the best indicator that the HO is "mature" and ready for resection?

A 32-year-old male with a severe traumatic brain injury develops rigid ankylosis of his right elbow secondary to heterotopic ossification (HO). When planning surgical excision, which of the following is considered the most reliable indicator that the HO is mature enough for resection?

A 40-year-old man who sustained a severe traumatic brain injury 4 months ago develops progressively decreasing range of motion in his right elbow due to neurogenic heterotopic ossification (HO). When is the most appropriate timing to surgically resect the HO?

A 30-year-old male sustained a severe traumatic brain injury and subsequently developed clinically significant heterotopic ossification (HO) ankylosing his right elbow. When evaluating the optimal timing for surgical excision of the HO, which of the following is the most reliable indicator that the bone is mature enough to minimize recurrence?

In a patient diagnosed with Nail-Patella Syndrome (Hereditary Osteo-onychodysplasia), which of the following extra-skeletal manifestations is most critical to monitor due to its impact on long-term survival?

A 6-year-old boy is evaluated for painless, limited forearm rotation. Radiographs demonstrate an isolated posterior dislocation of the radial head. Which of the following radiographic features most strongly supports a congenital rather than a traumatic etiology?

A 14-year-old female diagnosed with an LMX1B mutation presents with knee pain. Radiographs demonstrate absent patellae and posterior iliac horns. Which joint anomaly is also classically expected in this patient?

A 5-year-old child with severe Sprengel deformity is scheduled for a Woodward procedure to improve shoulder abduction and cosmesis. Which structures are typically detached from the spinous processes and translated inferiorly during this surgery?

A 6-year-old boy is evaluated for a high-riding left scapula and restricted shoulder abduction. Imaging confirms a fibrous connection between the superior angle of the scapula and the cervical spine. During surgical correction via the Woodward procedure, which muscle origin is detached and moved inferiorly?

A 10-year-old boy with multiple hereditary exostoses is being evaluated in the orthopedic clinic. Which of the following forearm deformities is most characteristic of this condition due to anarchic growth at the physes?