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Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
A 27-year-old minor league baseball pitcher presents to your office complaining of vague, deep shoulder pain which worsens during the late cocking phase of his throwing cycle. He also reports a recent decrease in velocity. He denies any history of instability. On examination, he has full strength with shoulder abduction, negative empty can test, as well as weakness with shoulder external rotation and resisted cross-body adduction. Radiographs are unremarkable and an MRI is obtained which demonstrates a tear of the posterior labrum with an adjacent paralabral cyst. Given this history, which of the following structures seen on the reference MRI in Figure A would be be expected to be affected?
Structures 1 & 5
Structures 3 & 4
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A 17-year-old male high school baseball pitcher presents to your office complaining of posterior shoulder pain and weakness. His father says his coaches have reported a decrease in velocity as of late. On clinical examination he has an abnormal O’Brien’s test and weakness in external rotation with the arm by his side. He has 5/5 strength with empty can testing. Radiographs do not show any abnormalities and MRI is seen in Figure A. Based on his diagnosis, which muscle would be affected and at risk for atrophy without intervention?
A 35-year-old athlete presents with chronic left shoulder pain with worsening external rotation weakness when his elbow is at his side. He has full external rotation when his arm is elevated. His clinical picture is depicted in Figure A. If an MRI is obtained, which of the following images (Figures B-F) would most likely be found?
Figure A is the MRI image of a 27-year-old tennis player who presents with a 3-month history of shoulder pain and weakness. Which of the following muscles would most likely present with weakness?
A & B
B & C
A 27-year-old volleyball player complains of worsening right posterolateral shoulder pain and weakness for the past 4 weeks. She denies any injury to the shoulder. Her examination reveals 5/5 muscle strength with shoulder elevation, abduction and internal rotation. She is found to have weakness in external rotation with the elbow at the side and gross inspection is remarkable for mild atrophy along the posterior scapula. She has an unremarkable lift-off test. Which nerve and corresponding site of compression is most likely responsible?
Suprascapular nerve and Suprascapular notch
Axillary nerve and Quadrilateral space
Suprascapular nerve and Spinoglenoid notch
Upper subscapular nerve and Spinoglenoid notch
Radial nerve and Triangular interval
Figure A and B are MRI images of a 42-year-old male with symptoms of right shoulder neuropathy. If this patient has an abnormality detected on EMG and nerve conduction testing, which of the following nerves is most likely to be involved?
Long thoracic nerve
A 22-year-old right-handed semi-professional baseball player complains of right shoulder pain and progressive weakness. He denies any traumatic events. His exam is noted to have a normal "empty can" and "belly press" tests. Resisted external rotation with the arm at the side does exhibit weakness. His MRI images are shown in figure A and B. What is the most likely cause of his symptoms?
Suprascapular nerve entrapment at the suprascapular notch
Suprascapular nerve entrapment at the spinoglenoid notch
Axillary nerve entrapment in the posterior triangle
Axillary nerve entrapment in the axillary pouch
Axillary nerve entrapment at near inferior neck of glenoid
A 44-year-old male presents with a 2 month history of posterior shoulder pain. He is noted to have normal forward flexion and abduction strength and isolated weakness on shoulder external rotation. He has slight atrophy of his periscapular area. He has no numbness or paraesthesias. Which pathology would best explain his symptoms?
Cranial nerve XI palsy
Spinoglenoid notch cyst
Axillary nerve palsy
Suprascapular notch cyst
A 29-year-old male volleyball player presents with a one year history of right shoulder weakness and deep aching pain. He denies any history of trauma or prior shoulder problems. A clinical photograph and representative sagittal MRI image are shown in Figures A and B respectively. He is diagnosed with a ganglion cyst of the shoulder. Based on the images provided, where is the cyst located?
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?
Positive impingement sign
Positive active compression
Weakness of external rotation
Weakness of abduction
A 22-year-old professional baseball catcher has posterior shoulder pain and severe external rotation weakness with the arm in adduction. Radiographs are normal. MRI scans are shown in Figures 15a through 15c. Management should consist of
aspiration and steroid injection.
arthroscopic repair and decompression.
A 34-year-old competitive weightlifter presents with increasing pain during bench pressing. Despite modifications in his workout, he is unable to compete. His physical exam demonstrates weakness in external rotation. Radiographs are unremarkable. His MRI findings are seen in Figure A. Treatment should include which of the following?
Refrain from weightlifting for a minimum of 6 weeks
Physical therapy with rotator cuff strengthening
Suprascapular cyst decompression
Infraspinatus rotator cuff repair and acromioplasty
Spinoglenoid cyst decompression with posterior labral repair
A patient with shoulder pain and weakness has an MRI showing a cyst in the suprascapular notch. Which of the following muscles is most likely to show weakness?
Supraspinatus and infraspinatus
A 24-year-old avid volleyball player has noted gradual onset of shoulder fatigue and weakness limiting his game. Radiographs done by his primary care physician were normal and he has failed to improve with 6 weeks of physical therapy. Given the MRI image shown in Figure A, this patients physical exam may reveal weakness with which of the following actions?
Abduction and external rotation
A 21-year-old collegiate volleyball player is noted to have weakness in external rotation and isolated atrophy of the infraspinatus on physical examination as seen in Figure A. An axial MRI image is shown in Figure B. This clinical condition is most likely caused by compression of the:
Axillary nerve at the triangular space
Suprascapular nerve in the suprascapular notch
Axillary nerve in the quadrangular space
Suprascapular nerve in the spinoglenoid notch
Long thoracic nerve anterior to the scalenus and the first rib and posterior to the clavicle
A patient is scheduled to undergo arthroscopy for a SLAP tear of his shoulder. Based on the sagittal images of the right shoulder MRI shown in Figure A, what additional physical exam finding is the patient likely to display?
Weakness in forward elevation
Weakness in internal rotation
Weakness in external rotation
Positive impingement maneuver
A 25-year-old volleyball player has recurrent right shoulder pain. On exam she has right shoulder weakness to external rotation with her arm at her side and atrophy below the scapular spine. There is no external rotation lag sign. Jobe drop arm and hornblower's tests are negative. The O'Brien's active compression test is positive. What will most likely be found on MRI of her shoulder?
Partial articular sided tear of the infraspinatus
Partial articular sided tear of the supraspinatus
Full thickness tear of the infraspinatus
Inferior labral tear with quadrangular space cyst
SLAP tear and spinoglenoid notch cyst