Sports Medicine Practice Questions

Q: Which ligament is primarily responsible for anteroposterior stability of the knee?

Anterior Cruciate Ligament (ACL). ***Anterior Cruciate Ligament (ACL)*** - The **ACL** is crucial for preventing the **anterior translation of the tibia** relative to the femur, thus providing significant **anteroposterior stability**. - It also plays a role in limiting **rotational stability** of the knee joint. *Medial collateral ligament (MCL)* - The **MCL** is located on the inner side of the knee and primarily resists **valgus stress** (force from the outside inward), preventing the knee from bending too far inward. - Its main function is to provide **medial stability**, not anteroposterior stability. *Lateral collateral ligament (LCL)* - The **LCL** is situated on the outer side of the knee and primarily resists **varus stress** (force from the inside outward), preventing the knee from bending too far outward. - It contributes to **lateral stability** of the knee. *Patellar ligament* - The **patellar ligament** connects the **patella** to the **tibial tuberosity** and is an extension of the quadriceps tendon. - Its primary role is in **knee extension**, acting as part of the extensor mechanism, and it does not directly contribute to anteroposterior or rotational stability.

Q: A 36-year-old man presents with an ankle injury sustained during a soccer match. What urgent intervention is required?

Applying a splint to stabilize the injury. ***Applying a splint to stabilize the injury*** - **Splinting** is a crucial urgent intervention for an ankle injury to **immobilize** the affected joint, reducing pain and preventing further damage to soft tissues or bone fragments. - It provides temporary stability until a definitive diagnosis and treatment plan can be established. *Performing a CT scan to assess the injury* - A **CT scan** is a diagnostic tool used to visualize complex fractures or soft tissue injuries in detail, but it is not an urgent intervention for initial management. - While important for diagnosis, it should typically follow initial stabilization and clinical assessment. *Immediate reduction of the dislocation* - **Reduction** is an urgent intervention for **dislocations**, but the question describes an "ankle injury," which could be a sprain, fracture, or dislocation. **Reduction** is only appropriate if a **dislocation** is confirmed. - Attempting to reduce a potential fracture without imaging can cause further trauma or pain. *Manipulation to restore alignment* - **Manipulation to restore alignment** is typically reserved for **dislocations** or certain types of **fractures** after proper imaging has been performed to understand the extent and type of injury. - Similar to reduction, it is not the universal first urgent intervention for an undiagnosed ankle injury.

Q: What is the most common site for osteochondritis dissecans in the elbow?

Capitulum. ***Capitulum*** - The **capitellum** (or capitulum) of the **humerus** is the most common site for **osteochondritis dissecans (OCD)** in the elbow. - This condition is often seen in young - **overhead athletes** due to repetitive valgus stress and microtrauma to the joint. *Trochlea* - While part of the distal humerus, the **trochlea** is less commonly affected by **OCD** compared to the capitulum. - The trochlea articulates with the **ulna** and is primarily involved in flexion and extension. *Radial head* - The **radial head** articulates with the capitulum but is not the most common location for primary elbow **OCD** lesions. - Injuries to the radial head are more often related to fractures or degenerative changes. *Olecranon* - The **olecranon** is located on the **ulna** and forms the tip of the elbow. - It is not a typical site for **osteochondritis dissecans**, which primarily affects articular cartilage and subchondral bone.

Q: Hill-Sach's lesion is seen in:

Recurrent dislocation of shoulder. ***Recurrent dislocation of shoulder*** - A **Hill-Sach's lesion** is a **compression fracture** of the posterolateral part of the humeral head, occurring as the humeral head impacts the anterior rim of the glenoid during **anterior shoulder dislocation**. - It is particularly associated with **recurrent anterior shoulder dislocations** due to repeated impaction. *Anterior dislocation of hip* - This condition involves the femoral head moving anteriorly out of the acetabulum and is not associated with a Hill-Sach's lesion. - While it causes significant pain and immobility, the specific bone lesion known as Hill-Sach's involves the humerus, not the femur. *Posterior dislocation of hip* - A posterior hip dislocation involves the femoral head moving posteriorly out of the acetabulum and is not linked to a Hill-Sach's lesion. - This type of injury is often seen in high-impact trauma, such as car accidents, and can be associated with acetabular fractures or sciatic nerve injury. *Posterior dislocation of shoulder* - This involves the humeral head dislocating posteriorly relative to the glenoid, and while bone lesions can occur, they are typically **reverse Hill-Sach's lesions** (on the anterior aspect of the humeral head) or **bony Bankart lesions** of the posterior glenoid. - A standard Hill-Sach's lesion specifically refers to the posterolateral humeral head defect seen in **anterior dislocations**.

Q: Lachman's test is performed with the knee in what degree of flexion?

20. ***20*** - The **Lachman's test** is most accurately performed with the knee in **20-30 degrees of flexion** to better isolate the **anterior cruciate ligament (ACL)**. - This neutral position allows the posterior capsule and other secondary restraints to be relaxed, making an **ACL tear** more evident during anterior translation of the tibia. *5* - Positioning the knee at only **5 degrees of flexion** is not ideal, as it may keep the **posterior capsule** under too much tension, potentially masking an **ACL injury**. - This position does not adequately relax the secondary stabilizers, which can lead to a false negative result for **ACL laxity**. *70* - At **70 degrees of flexion**, the knee is too bent to effectively assess the **ACL**. - In this position, the **menisci** and other structures can block clear anterior translation, and it is more common for other knee stability tests like the **anterior drawer test** to be performed. *90* - With the knee flexed to **90 degrees**, the **anterior drawer test** is typically performed, not the Lachman's test. - In this position, the **posterior horn of the menisci** can interfere with anterior translation, making the Lachman's test less sensitive for detecting an **ACL tear**.

Question 1

Which ligament is primarily responsible for anteroposterior stability of the knee?

Accepted Answer

Anterior Cruciate Ligament (ACL)

Answer

Medial collateral ligament (MCL)

Answer

Lateral collateral ligament (LCL)

Answer

Patellar ligament

Question 2

A 36-year-old man presents with an ankle injury sustained during a soccer match. What urgent intervention is required?

Accepted Answer

Applying a splint to stabilize the injury

Answer

Performing a CT scan to assess the injury

Answer

Manipulation to restore alignment

Answer

Immediate reduction of the dislocation

Question 3

What is the most common site for osteochondritis dissecans in the elbow?

Accepted Answer

Capitulum

Answer

Trochlea

Answer

Radial head

Answer

Olecranon

Question 4

Hill-Sach's lesion is seen in:

Accepted Answer

Recurrent dislocation of shoulder

Answer

Anterior dislocation of hip

Answer

Posterior dislocation of hip

Answer

Posterior dislocation of shoulder

Question 5

Lachman's test is performed with the knee in what degree of flexion?

Accepted Answer

20

Answer

5

Answer

70

Answer

90

Sports Medicine — MCQs

Sports Medicine — MCQs

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