Sports Medicine Practice Questions

Q: Ruptured tendons are most commonly seen in

Overuse. ***Overuse*** - Chronic **overuse** leads to **microtrauma and degeneration** within the tendon, weakening it over time and making it susceptible to rupture even with minimal acute stress. - This is particularly common in tendons that experience **repetitive strain**, such as the Achilles tendon, rotator cuff, and patellar tendon. *Direct trauma from injury* - While acute, high-impact **direct trauma** can cause tendon ruptures, it is not the most common mechanism overall. - Many traumatic ruptures occur in tendons already weakened by **chronic degeneration**, rather than purely healthy tendons. *Structural abnormalities from birth* - **Congenital structural abnormalities** are relatively rare causes of primary tendon rupture. - These conditions usually present earlier in life with functional limitations rather than sudden rupture in adulthood. *Tumor-related structural changes* - **Tumors** can, in rare cases, weaken tendons and lead to rupture, but this is a far less common cause compared to overuse. - Tendon compromise due to a tumor usually involves direct invasion or pressure, which is not the predominant etiology for the majority of tendon ruptures.

Q: Test for a tight iliotibial band is:

Ober's test. ***Ober's test*** - The **Ober's test** is specifically designed to assess for tightness in the **iliotibial band (ITB)**. - During the test, the patient lies on their side, and the examiner abducts and extends the hip, then attempts to adduct it; limited adduction indicates ITB tightness. *Osber's test* - **Osber's test** is not a recognized or standard orthopedic test for iliotibial band tightness. - This option appears to be a misspelling or an invented term for a diagnostic maneuver. *Simmand's test* - There is no widely recognized orthopedic test called **Simmand's test**. - This option is likely a distractor and does not correspond to a known clinical assessment. *Charnley's test* - **Charnley's test** is not a standard orthopedic test used to evaluate iliotibial band tightness. - While Charnley is a prominent figure in orthopedics (known for hip replacement), this test is not associated with his name or ITB assessment.

Q: Meniscal tears usually result from which of the following circumstances?

Flexion and rotation. ***Flexion and rotation*** - **Flexion and rotation** of the knee create significant shear and compressive forces on the meniscus, leading to tears, especially when the foot is planted. - This mechanism is common in sports that involve sudden changes in direction or twisting movements. *Hyperextension* - **Hyperextension** of the knee primarily stresses the anterior knee structures, such as the quadriceps tendon and anterior cruciate ligament (ACL), leading to sprains or tears in these structures rather than meniscal tears. - While severe hyperextension can potentially damage the meniscus, it is not the most common direct cause of meniscal tears. *Simple hyperflexion* - **Simple hyperflexion** primarily compresses the posterior aspects of the menisci but is less likely to cause a significant tear unless combined with a rotational force or extreme mechanical stress. - Deep squats or prolonged kneeling can cause discomfort or minor meniscal irritation but rarely result in acute tears in isolation. *Compression* - While **compression** is a component of the forces involved in meniscal tears, it alone is usually insufficient to cause a tear. - Significant tears most often result from a combination of **compression** with **rotational** or **shear forces**.

Q: In a case of recurrent anterior dislocation of the shoulder, posterolateral lesions were found on radiological examination. What are these lesions?

Hill-Sachs lesion. ***Hill-Sachs lesion*** - A Hill-Sachs lesion is an **impaction fracture** of the posterolateral aspect of the **humeral head** caused by its collision with the anterior glenoid rim during anterior shoulder dislocation. - Its presence is a common finding in **recurrent anterior shoulder dislocations**, as described in the case. *Bankart's lesion* - A Bankart's lesion is an injury to the **anterior-inferior labrum** of the glenoid, often involving an avulsion of the capsule attached to the labrum. - This lesion is typically located on the **glenoid side**, not the humeral head, and is caused by the humeral head forcing against the glenoid rim during dislocation. *Putti-Platt lesion* - A Putti-Platt lesion describes a tear or avulsion of the **subscapularis tendon** and capsule from the anterior aspect of the glenoid. - This lesion is less commonly encountered as a distinct radiographic finding in the same way as a Hill-Sachs or Bankart, and refers more to surgical repair. *Reverse Hill Sachs lesion* - A reverse Hill-Sachs lesion is an impaction fracture on the **anteromedial aspect** of the humeral head. - This lesion is characteristic of a **posterior shoulder dislocation**, which is not the case described in the question.

Q: Which of the following is NOT a characteristic of accessory nerve palsy?

Normal electromyographic finding. ***Normal electromyographic finding*** - Accessory nerve palsy affects the function of the **sternocleidomastoid** and **trapezius** muscles. An electromyographic (EMG) study would show **abnormal findings** such as fibrillations, positive sharp waves, and reduced motor unit recruitment in these muscles due to denervation. - Therefore, a finding of a normal EMG would indicate the **absence** of accessory nerve pathology. *Shoulder drooping* - This is a classic characteristic of accessory nerve palsy due to weakness of the **trapezius muscle**, which is responsible for maintaining shoulder posture. - The trapezius muscle helps to elevate and retract the scapula, and its paralysis leads to the **inferior displacement** of the shoulder on the affected side. *Pain* - **Chronic pain** in the neck and shoulder area is a common symptom associated with accessory nerve palsy. - This pain can result from muscle imbalance, spasticity, or compensatory mechanisms by other muscles trying to **overcome the weakness**. *Restricted range of movement* - Weakness of the **trapezius** and **sternocleidomastoid muscles** directly impacts the ability to perform certain movements, such as shrugging the shoulders (trapezius) and turning the head to the opposite side (sternocleidomastoid). - This leads to a **limited ability** to actively elevate the arm above 90 degrees and **difficulty rotating the head** against resistance.

Q: What is the condition commonly known as jumper's knee?

Patellar tendonitis due to overuse of the patellar tendon.. ***Patellar tendonitis due to overuse of the patellar tendon.*** - **Jumper's knee** is the common term for **patellar tendonitis**, which specifically refers to inflammation of the patellar tendon. - This condition is frequently caused by **overuse**, especially in activities involving repetitive jumping and landing. *Inflammation of the patellar tendon at its insertion on the patella.* - While jumper's knee does involve inflammation of the patellar tendon, it is more commonly at its insertion on the **tibial tubercle** or specifically its origin at the **inferior pole of the patella**, not necessarily at the patella itself. - This option is less precise as it describes only one aspect of the condition without mentioning the critical role of overuse. *Tendinopathy of the quadriceps tendon.* - **Tendinopathy of the quadriceps tendon** is a distinct condition affecting the tendon above the patella, known as **quadriceps tendinopathy**. - It presents with pain proximal to the patella, differentiating it from jumper's knee, which involves the tendon distal to the patella. *Injury to the hamstring tendon.* - An **injury to the hamstring tendon** would cause pain and symptoms on the posterior aspect of the knee or thigh. - This is completely unrelated to jumper's knee, which is characterized by anterior knee pain.

Q: What condition is characterized by pain and tenderness on the medial epicondyle due to overuse of wrist flexors?

Medial epicondylitis. ***Medial epicondylitis*** - This condition involves inflammation and degeneration of the tendons originating from the **medial epicondyle**, primarily due to repetitive **wrist flexion** and pronation. - Patients typically experience **pain and tenderness** directly over the medial epicondyle, often exacerbated by gripping or wrist movements. *Lateral epicondylitis* - This condition affects the tendons originating from the **lateral epicondyle**, specifically the extensor muscle group, due to overuse of **wrist extensors**. - Pain and tenderness would be located on the **lateral aspect** of the elbow, not the medial side. *Posterior elbow dislocation* - This is a traumatic injury involving the displacement of the **ulna and radius posterior** to the humerus. - It presents with severe pain, obvious deformity, and inability to move the elbow, which is a very different clinical picture from chronic overuse pain. *Lateral collateral ligament injury* - This involves damage to the **ligament on the outside of the elbow**, often due to a varus stress injury. - Symptoms would include pain and instability on the **lateral side** of the elbow, particularly with varus stress testing, not medial epicondyle tenderness from overuse of wrist flexors.

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: 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

Ruptured tendons are most commonly seen in

Accepted Answer

Overuse

Answer

Direct trauma from injury

Answer

Structural abnormalities from birth

Answer

Tumor-related structural changes

Question 2

Test for a tight iliotibial band is:

Accepted Answer

Ober's test

Answer

Osber's test

Answer

Simmand's test

Answer

Charnley's test

Question 3

Meniscal tears usually result from which of the following circumstances?

Accepted Answer

Flexion and rotation

Answer

Hyperextension

Answer

Simple hyperflexion

Answer

Compression

Question 4

In a case of recurrent anterior dislocation of the shoulder, posterolateral lesions were found on radiological examination. What are these lesions?

Accepted Answer

Hill-Sachs lesion

Answer

Bankart's lesion

Answer

Reverse Hill Sachs lesion

Answer

Putti-Platt lesion

Question 5

A 35-year-old tennis player presents with pain on the outer aspect of the elbow that worsens with gripping activities and wrist extension. The pain is localized over the lateral epicondyle. This condition most likely involves:

Accepted Answer

Inflammation of the extensor tendons at the lateral epicondyle of the humerus

Answer

Inflammation of the flexor tendons at the medial epicondyle of the humerus

Answer

Inflammation of the biceps tendon at the shoulder

Answer

Inflammation of the triceps tendon at the elbow

Question 6

Which of the following is NOT a characteristic of accessory nerve palsy?

Accepted Answer

Normal electromyographic finding

Answer

Shoulder drooping

Answer

Pain

Answer

Restricted range of movement

Question 7

What is the condition commonly known as jumper's knee?

Accepted Answer

Patellar tendonitis due to overuse of the patellar tendon.

Answer

Inflammation of the patellar tendon at its insertion on the patella.

Answer

Tendinopathy of the quadriceps tendon.

Answer

Injury to the hamstring tendon.

Question 8

What condition is characterized by pain and tenderness on the medial epicondyle due to overuse of wrist flexors?

Accepted Answer

Medial epicondylitis

Answer

Lateral epicondylitis

Answer

Posterior elbow dislocation

Answer

Lateral collateral ligament injury

Question 9

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

Accepted Answer

Capitulum

Answer

Trochlea

Answer

Radial head

Answer

Olecranon

Question 10

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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