AAOS Orthopedic MCQs (Set 1): THA Nerve Palsy & Exostoses | 2026 Board Exam Prep

A 28-year-old professional dancer reports a 3-month history of progressive pain in the posterior aspect of the left ankle. Her symptoms are worse when she assumes the en pointe position. Examination reveals tenderness to palpation at the posterolateral aspect of the ankle posterior to the peroneal tendons which is made worse with passive plantar flexion. There is no nodularity, fluctuance, or tenderness of the Achilles tendon. The neurovascular examination is unremarkable. A lateral radiograph and MRI scan are shown in Figures 16a and 16b, respectively. Management should consist of

Which of the following factors has the greatest effect on the pull-out strength of a lumbar pedicle screw?

Examination of the shoulder seen in Figure 52 shows atrophy and tenderness of the infraspinous fossa and profound weakness in external rotation. The supraspinous fossa shows normal muscle bulk. What is the most likely cause of this condition?

Figures 11a and 11b show the AP and lateral radiographs of a 32-year-old patient on hemodialysis who has increasing elbow pain and a visibly growing mass over the extensor surface. Figure 11c shows the photomicrograph of the biopsy specimen. What is the most likely diagnosis?

Injury to which of the following structures has been reported following iliac crest bone graft harvest?

Figures 34a and 34b show the clinical photographs of a 46-year-old woman who has a painful deformity of the second toe. Surgical treatment consisting of metatarsophalangeal capsulotomy and proximal interphalangeal joint resection arthroplasty resulted in satisfactory correction, but the toe remains unstable at the metatarsophalangeal joint. What is the next most appropriate step?

A 51-year-old male truck driver has had progressive left hip pain for more than 2 years, and he reports that the pain has become severe in the past 9 months. He is now unable to work because of the pain. Examination reveals that range of motion of the hip is limited to 95 degrees of flexion, 0 degrees of internal rotation, and 20 degrees of external rotation. The plain radiograph, MRI scan, and intraoperative gross photographs are shown in Figures 9a through 9d. Management should consist of

During an anterior approach to the shoulder, excessive traction on the conjoined tendon is most likely to result in loss of

A 57-year-old woman with diabetes mellitus has purulent drainage from a lateral incision after undergoing open reduction and internal fixation of a displaced ankle fracture 10 days ago. Examination reveals moderate erythema and a foul odor coming from the wound. Cultures are obtained. What is the next most appropriate step in management?

Which of the following studies is considered most sensitive in monitoring a therapeutic response in acute hematogenous osteomyelitis?

Which of the following is not a reported mode of failure for a constrained acetabular component?

A 21-year-old man has had posterior neck discomfort for the past 6 months. Radiographs, an MRI scan, and a photomicrograph of the biopsy specimen are shown in Figures 17a through 17d. What is the most likely diagnosis?

Figure 13 shows the radiographs of a 20-year-old intercollegiate basketball player who was injured 6 weeks prior to the start of the season. What is the most appropriate treatment?

Figure 29 shows the radiograph of a 55-year-old patient who has recurrent total hip dislocation. Dislocation is most likely to occur in this patient when the hip is in which of the following positions?

An axillary nerve lesion may cause weakness in the deltoid and the

What is the most significant prognostic factor in nontraumatic osteonecrosis of the humeral head?

A 72-year-old woman who is right hand-dominant has severe pain in the right shoulder that has failed to respond to nonsurgical management. She reports night pain and significant disability. Examination reveals 30 degrees of active forward elevation. An AP radiograph is shown in Figure 27. Which of the following treatment options will provide the best functional improvement?

A 19-year-old football player who sustained three traumatic anterior shoulder dislocations underwent surgery to repair a Bankart lesion. Nine months after surgery, examination reveals stability, elevation to 150 degrees, external rotation to 0 degrees with the elbow at his side and to 50 degrees at 90 degrees of abduction, and internal rotation to T12. If his range of motion does not improve, he is at most risk for

Which of the following patient factors is associated with recurrent radicular pain following lumbar diskectomy for sciatica?

A 45-year-old man has had left thigh pain for the past 4 months. An AP radiograph, bone scan, MRI scans, and biopsy specimens are shown in Figures 6a through 6f. What is the most appropriate treatment?

Figures 48a and 48b show the radiographs of a 26-year-old woman who fell down two steps and twisted her foot and ankle. What is the most appropriate treatment for this injury?

A 45-year-old woman has had radiating pain in the medial ankle for the past 3 months. Examination reveals a small mass in the retromedial ankle region and a positive Tinel's sign. An intraoperative photograph and a hematoxylin/eosin biopsy specimen are shown in Figures 24a and 24b. Treatment should consist of

Which of the following mechanisms of inhibition has been linked to cigarette smoking and lumbar spinal fusion?

A patient undergoes the procedure shown in Figure 19. An important part of this procedure is preservation of what wrist ligament?

Figure 1 shows the radiograph of an 18-year-old patient who has severe knee pain. Treatment consisting of osteotomy should be perfomed

Which of the following is considered the most predictive factor in determining whether a patient will need a blood transfusion after total knee arthroplasty?

Figures 20a and 20b show the radiographs of a 14-year-old boy who sustained a twisting injury to his ankle. If attempted closed reduction is unsuccessful, what is the primary reason to proceed with surgical treatment?

While lifting weights, a patient feels a pop in his arm. He has the deformity shown in Figure 30. If left untreated, the patient will have the greatest deficiency in

Iliosacral screws placed for stabilization of posterior pelvic ring injuries (eg, sacroiliac dislocation) that exit the sacrum anteriorly are most likely to injure which of the following structures?

Which of the following orthotic features best reduces pain in patients with hallux rigidus?

Which of the following statements regarding conus medullaris syndrome is most accurate?

Figures 11a and 11b show the AP and lateral radiographs of a 32-year-old patient on hemodialysis who has increasing elbow pain and a visibly growing mass over the extensor surface. Figure 11c shows the photomicrograph of the biopsy specimen. What is the most likely diagnosis?

The quadrilateral space in the shoulder contains which of the following structures?

What is the correct order of the elastic modulus of the following materials from greatest to least?

A 25-year-old woman with a healed proximal tibiofibular fracture treated with an intramedullary nail 2 years ago is currently wearing an ankle-foot orthosis (AFO) and reports a persistent foot drop. She is unhappy with the AFO and has not seen any functional improvement despite months of physical therapy. Serial electromyograms (EMG) show no recent change over the past year. Examination and EMG findings are consistent with a tibialis anterior 1/5, extensor hallucis longus 2/5, extensor digitorum longus 2/5, posterior tibial tendon (PTT) 5/5, peroneals 3/5, flexor hallucis longus 5/5, and gastrocsoleus 5/5. No discrete nerve lesion was identified. The patient has a flexible equinovarus contracture. What is the most appropriate management?

A 52-year-old woman with diabetes mellitus has had a plantar foot ulcer under the second metatarsal head for the past week. The patient had a similar ulcer 2 months ago, and total contact casting resulted in healing. Examination reveals no signs of infection. What procedure will best prevent recurrence of the ulcer?

A previously asymptomatic 40-year-old man injures his shoulder in a fall. Examination shows that he is unable to lift the hand away from his back while maximally internally rotated. An axial MRI scan of the shoulder is shown in Figure 14. What is the most likely diagnosis?

Medial dislocation of the long head of the biceps tendon in the shoulder is most commonly caused by a

A patient underwent an anterior cervical diskectomy and interbody fusion for a C5-6 herniated nucleus pulposus and left C6 radiculopathy 8 months ago. He now reports new onset of severe neck pain and left C6 radicular pain, with wrist extension weakness. The radiograph and CT scan shown in Figures 26a and 26b reveal pseudarthrosis at C5-6. The next step in management should consist of

A 13-year-old girl has had increasing left hip pain for the past 4 months. A radiograph, bone scan, MRI scan, and photomicrograph are shown in Figures 1a through 1d. Which of the following immunohistochemistry results would confirm the most likely diagnosis?

What is the most appropriate indication for replantation in an otherwise healthy 35-year-old man?

A 55-year-old woman undergoes an anterior cervical diskectomy and fusion at C5-C6 through a left-sided approach. One year later, she requires an anterior cervical diskectomy and fusion on another level. Which of the following is considered a contraindication to performing a right-sided approach for the revision procedure?

A 10-year-old boy with severe hemophilia A (factor VIII) sustained an injury to his right forearm 2 hours ago when a classmate fell on his arm during a scuffle. Examination reveals moderate swelling in the forearm, decreased sensation in the distribution of the median and ulnar nerves, and pain on passive extension of the fingers. What is the most appropriate sequence of treatment?

Which of the following describes the correct proximal to distal progression of the annular and cruciform pulleys of the digits?

A 13-year-old boy has knee pain after sustaining a mild twisting injury while playing basketball 4 weeks ago. Radiographs and MRI scans are shown in Figures 24a through 24d, and biopsy specimens are shown in Figures 24e and 24f. Treatment should consist of

A 13-year-old girl injures her ankle playing soccer. Radiographs reveal a displaced Tillaux fracture. CT scans are shown in Figure 25. What is the most important consideration for appropriate management?

The correct starting point for an external fixation half pin placed into the anterior inferior iliac spine (AIIS) is labeled by what letter in Figure 3?

Which of the following bearing materials is most resistant to scratching from third-body debris?

In the radiograph shown in Figure 42, the fracture pattern around this well-fixed stem is classified as Vancouver type

Figure 23 shows the radiograph of a 55-year-old man who underwent a total hip arthroplasty 5 years ago. Management should now consist of

The brachialis muscle is innervated by what two nerves?

Following a fall from a height of 5 feet, a patient reports pain along the lateral border of the foot. The CT scan shown in Figure 54 indicates what pathology?

Figures 36a and 36b show the MRI scans of a patient who has shoulder weakness. What is the most likely diagnosis?

What pharmacologic agents are preferred for the treatment of symptomatic active Paget's disease?

A 21-year-old patient has had pain and a marked decrease in active and passive shoulder motion after having had a seizure 2 months ago as the result of alcohol abuse. Current AP and axillary radiographs and a CT scan are shown in Figures 26a through 26c. Management should consist of

Figures 28a and 28b show AP and lateral radiographs of the knee. Based on these findings, which of the following structures has most likely been injured?

A 16-year-old football player sustains a direct blow to the anterior aspect of his flexed right knee. Examination reveals a contusion over the anterior tibial tubercle and a small effusion. MRI scans are shown in Figures 33a through 33c. What is the most likely diagnosis?

Figure 5 shows the radiograph of a 10-year-old girl who reports chronic shoulder pain after her gymnastics classes. Examination reveals pain on internal and external rotation but no instability. What is the most likely diagnosis?

A 68-year-old woman with a history of rheumatoid arthritis has had neck pain and weakness in all four extremities that has become worse in the past 6 months. She has gone from a community to a household ambulator and uses a wheelchair outside of the home. Examination of the extremities reveals poor coordination, diffuse weakness, hyperactive reflexes, and bilateral sustained clonus. She has a broad-based and unsteady gait. The posterior atlanto-dens interval is 12 mm. Based on these findings and the radiograph and MRI scan shown in Figures 13a and 13b, the treatment of choice is surgical decompression and stabilization. However, the patient inquires about the prognosis with surgery compared to nonsurgical management. Assuming there are no complications from surgery, the patient should be informed that, with surgery, she will most likely

Which of the following factors is most commonly associated with mechanical failure of a cemented total hip arthroplasty?

The artery located within the substance of the coracoacromial ligament is a branch of what artery?

Which of the following best describes the course of the median nerve at the elbow?

Resuscitation of a trauma patient who has been in hypovolemic shock is complete when which of the following has occurred?

A 12-year-old Little League pitcher reports lateral elbow pain and "catching." Examination reveals painful pronation and supination and tenderness over the lateral elbow. Radiographs are shown in Figures 22a and 22b. Initial management should consist of

A 12-year-old girl has progressive development of cavus feet. Examination reveals slightly diminished vibratory sensation on the bottom of the foot. Reflexes are 1+ at the knees and ankles. Motor examination shows that all muscles are 5/5 in the foot, except the peroneal and anterior tibial muscles are rated as 4+/5. Which of the following studies is considered most diagnostic?

A characteristic genetic translocation has been noted in which of the following tumors?

A patient who has had neck pain radiating down the arm for the past 4 weeks reports that the pain was excruciating during the first week. Management consisting of anti-inflammatory drugs and physical therapy has decreased the neck and arm symptoms from 10/10 to 3/10. He remains neurologically intact. MRI and CT scans are shown in Figures 5a and 5b. The best course of action should be

A 79-year-old woman with polyarticular rheumatoid arthritis has had progressively increasing right shoulder pain for the past year, and nonsurgical management has failed to provide relief. Her neurologic examination is entirely normal, but she is unable to elevate her arm against gravity. An AP radiograph is shown in Figure 13. Treatment should consist of

Figures 51a and 51b show subluxation of the

A 42-year-old patient has had painful inferior subluxation of the glenohumeral joint following a recent cerebrovascular accident (CVA). Figure 34 shows the AP radiograph of the shoulder. Management should consist of

A patient who underwent open reduction and internal fixation of an olecranon fracture 2 months ago now reports painless limitation of motion. Examination reveals a well-healed incision and a flexion-extension arc from 40 degrees to 80 degrees. The patient has been performing home exercises. Radiographs are shown in Figures 26a and 26b. What is the most appropriate treatment?

Figure 50 shows the cross table lateral radiograph of a 31-year-old paratrooper who has recalcitrant groin pain. The pain is worse after activities such as standing or sitting (driving). Examination reveals that pain can be reproduced by internal rotation of the leg with the hip and knee in 90 degrees of flexion. Extensive nonsurgical managment has failed to provide relief. What is the treatment of choice?

An 18-year-old boy has had pain in the right knee for the past 6 months. Examination reveals some fullness behind the knee but no significant palpable soft-tissue mass. There is no effusion, and he has full knee range of motion. The remainder of the examination is unremarkable. A radiograph and MRI scans are shown in Figures 33a through 33c, and biopsy specimens are shown in Figures 33d and 33e. What is the most likely diagnosis?

A 37-year-old laborer falls 12 feet and sustains a comminuted tibial plafond fracture. Three years after treatment using standard techniques, what will be the most likely outcome?

Which of the following statements best describes why the ulnar nerve is most prone to neuropathy at the elbow?

Figures 27a and 27b show the radiographs of a 32-year-old woman who was involved in a high-speed motor vehicle accident. She is neurologically intact. After stabilization and assessment, treatment should consist of

An eversion mechanism of injury is associated with which of the following ankle conditions?

A 24-year-old athlete has a painful right shoulder. Figure 30 shows an intra-articular photograph that was obtained through a posterior portal during arthroscopy; the labrum is indicated by the arrow. Based on these findings, management should consist of

The first branch of the lateral plantar nerve innervates the

Which of the following cardiac conditions is considered an absolute contraindication to vigorous exercise?

A 13-year-old girl is diagnosed with a stage IIB osteosarcoma of the proximal tibia. Following neoadjuvant chemotherapy, local control should consist of

A 22-year-old volleyball player reports the insidious onset of superior and posterior shoulder pain. Radiographs are normal. An MRI scan is shown in Figure 25. What is the most specific physical examination finding?

A 62-year-old man with diabetes mellitus has had a persistent 2-cm ulcer under the third metatarsal head for the past 4 months. He reports that he has had similar ulcers twice before, and both healed with nonsurgical management. He has used multiple types of commercial walking braces, shoes, and commercial dressings without resolution. He is insensate to the Semmes-Weinstein 5.07 monofilament. When the wound is probed with culture swab, there is no communication with the metatarsal head. Radiographs, bone scans, and laboratory studies reveal no evidence of osteomyelitis. What is the most predictable method of accomplishing wound healing without recurrence?

Myositis ossificans is a recognized complication of contusion to the quadriceps muscle. During early rehabilitation, this condition is most likely to be exacerbated by

The mother of a healthy 8-month-old boy reports that her son refuses to use his left arm. Examination reveals that the arm hangs limp at his side in an adducted and internally rotated position, and the affected shoulder subluxates posteriorly. Passive external rotation measures 15 degrees. Management should consist of

A patient has right shoulder pain. Figure 1a shows a gadolinium-enhanced transverse MRI scan at the level of the coracoid. Figure 1b shows an arthroscopic view of the anterior structures from a posterior portal. These images reveal which of the following findings?

A 75-year-old woman has had severe shoulder pain for the past month. Her medical history includes hypertension and a total nephrectomy for renal cell carcinoma 7 years ago. Radiographs and sagittal MRI scans are shown in Figures 36a through 36d. A bone scan reveals this to be an isolated lesion. Biopsy findings are consistent with metastatic renal cell carcinoma. What is the most appropriate treatment for this patient?

Which of the following patients is considered the most appropriate candidate for an isolated split posterior tendon transfer?

Figures 47a through 47f show the AP radiograph, bone scan, CT scan, MRI scan, and biopsy specimens of a 30-year-old woman who has had vague left shoulder pain for 1 year. Management should consist of

The injection shown in Figures 1a and 1b would most benefit a patient who reports which of the following symptoms?

A 21-year-old patient has had pain and a marked decrease in active and passive shoulder motion after having had a seizure 2 months ago as the result of alcohol abuse. Current AP and axillary radiographs and a CT scan are shown in Figures 26a through 26c. Management should consist of

A 43-year-old former professional hockey player reports severe pain in his chest after being checked from the side in a pick-up hockey game. An MRI scan and plain radiographs are shown in Figures 25a through 25c. What is the most likely diagnosis?

What patient factor is predictive of better outcomes for surgical management of a displaced calcaneal fracture compared to nonsurgical management?

Which of the following is considered the cause of Milwaukee shoulder, a joint disease similar to rotator cuff arthropathy?

A 32-year-old man sustains multiple injuries in a motorcycle accident including ipsilateral open right femur and comminuted tibia fractures. He has acute abdominal distention and tenderness to palpation. The pelvis is stable to examination. He has a blood pressure of 70/40 mm Hg despite appropriate fluid resuscitation and a pulse rate of 120/min; the pulse is thready. Which of the following procedures is considered the highest priority in the management of this patient?

A 49-year-old woman noted pain in her right axilla 1 day after moving heavy furniture. Two weeks later, she now reports persistent numbness and paresthesias along the inner aspect of her upper arm radiating into the ulnar digits. Examination reveals full shoulder motion, tenderness over the first rib, and a decreased radial pulse with the shoulder placed overhead. What is the most likely diagnosis?

A 23-year-old woman reports right knee pain and fullness. The pain is worse with activity but also present at rest. Radiographs are shown in Figures 20a and 20b. What is the most likely diagnosis?

Figures 32a and 32b show the radiographs of a 13-year-old boy who sustained a fracture while playing football 1 week ago. Management at the time of injury included application of a cast and the use of crutches. A follow-up office visit reveals a normal neurologic examination, and the patient reports no discomfort with the cast and crutches. Management should now include

A 55-year-old woman with a history of untreated idiopathic scoliosis has had neurogenic claudication for the past several months. MRI reveals spinal stenosis at L2-L3, L3-L4, and L4-L5. Radiographs show a 45-degree lumbar curve from T10 to L4, with a degenerative spondylolisthesis at L4-L5. Laminectomy at the stenotic levels and stabilization of the deformity are planned. Which of the following is NOT considered an absolute indication for extending the fusion to the sacrum, rather than stopping at L5?

A 38-year-old man who is an avid tennis player has had persistent pain over the medial aspect of his knee for the past 6 years. He notes that the pain occurs on a daily basis with any significant activity. Nonsteroidal anti-inflammatory drugs have failed to provide relief. Radiographs are shown in Figures 22a and 22b. What is the best course of action?