2026
Sports Medicine Scored and Recorded Self-Assessment Examination 2026
,Question 1 of 100
Based on the injury shown on the axial MRI scan of the shoulder in Figure 1, what other pathology
should be closely examined for during surgery?
Figure 1
A. Subscapularis tear
B. Supraspinatus tear
C. Superior labral anterior-posterior (SLAP) tear
D. Bankart tear
Correct answer: A
• Discussion
The axial MRI scan reveals a subluxated biceps tendon. In the study by Koh and associates, 85% of
patients with a biceps subluxation on MRI were found to have a subscapularis tear at the time of
arthroscopy. These are not always obvious on the MRI, and close inspection of the leading edge/upper
border of the subscapularis tendon at the time of arthroscopy is necessary. Although supraspinatus
tears, SLAP tears, and Bankart tears can all occur in conjunction with a biceps subluxation, none have
been shown to be strongly correlated with this pathology, nor as specific to this pathology.
• Recommended Readings
,Shi LL, Mullen MG, Freehill MT, Lin A, Warner JJ, Higgins LD. Accuracy of long head of the
biceps subluxation as a predictor for subscapularis tears. Arthroscopy. 2015 Apr;31(4):615-9.
doi: 10.1016/j.arthro.2014.11.034. Epub 2015 Jan 28. PubMed
Koh KH, Kim SC, Yoo JC. Arthroscopic Evaluation of Subluxation of the Long Head of the
Biceps Tendon and Its Relationship with Subscapularis Tears. Clin Orthop Surg. 2017
Sep;9(3):332-339. doi: 10.4055/cios.2017.9.3.332. Epub 2017 Aug 4. PubMed
Question 2 of 100
Figure 1 is the radiograph of a 31-year-old man who had left shoulder pain after a fall during a
snowboarding jump. Residual displacement of 5 mm after closed reduction is most likely to result in
Figure 1
A. nonunion.
B. osteonecrosis.
C. altered rotator cuff mechanics.
D. normal shoulder function.
, CorrectKanswer:KC
• Discussion
HumerusKfracturesKaccountKforK11%KofKallKfracturesKamongKsnowboardersKandKareKtheKsecond-most-
KcommonKupper-
extremityKfractureKafterKradiusKfracturesK(48%).KSurgicalKfixationKisKrecommendedKforKfracturesKwithKresi
dualKdisplacementK>5Kmm,KorK>3KmmKinKactiveKpatientsKinvolvedKinKfrequentKoverheadKactivity.KMalunion
KcanKresultKinKaKmechanicalKblockKtoKshoulderKabductionKorKexternalKrotationKandKalteredKrotatorKcuffKme
chanics,KcausingKweakness.KAKrichKarterialKnetworkKprovidesKaKfavorableKhealingKenvironmentKforKgreate
rKtuberosityKfractures.KConsequently,KnonunionKandKosteonecrosisKareKuncommon.
• RecommendedKReadings
BissellKBT,KJohnsonKRJ,KShafritzKAB,KChaseKDC,KEttlingerKCF.KEpidemiologyKandKriskKfactorsK
ofKhumerusKfracturesKamongKskiersKandKsnowboarders.KAmKJKSportsKMed.K2008KOct;36(10):188
0-8.KEpubK2008KJulK1.KPubMed
GeorgeKMS.KFracturesKofKtheKgreaterKtuberosityKofKtheKhumerus.KJKAmKAcadKOrthopKSurg.K200
7KOct;15(10):607-13.KFullKtext
Question 3 of 100
K K K
AK23-year-
oldKstudentKcomplainsKofKrecurrentKleftKshoulderKinstability.KHeKfirstKdislocatedKhisKshoulderKinKhighKscho
olKwhileKplayingKlacrosseKandKwasKmanagedKwithKphysicalKtherapy.KAKsecondKdislocationKoccurredKoneKye
arKlaterKwhileKskiing.KHeKhasKsinceKsustainedKtwoKmoreKdislocationsKandKsaysKthatKhisKshoulderKfeelsK“loo
se.”KExaminationKrevealsKgradeKIIKanteriorKloadKandKshift,KpositiveKapprehensionKandKrelocationKtests,Kan
dKnormalKrotatorKcuffKstrength.KAnKMRIKarthrogramKisKorderedKandKsurgicalKtreatmentKisKrecommended.K
WhatKfactorKwouldKmostKstronglyKrepresentKanKindicationKforKaKprocedureKincludingKboneKaugmentation
K(e.g.KLatarjet)KratherKthanKaKsoft-tissue-onlyKstabilizationK(isolatedKlabralKrepair/capsulorrhaphy)?
A. Patient’sKintentionKtoKresumeKlacrosseKandKotherKcontactKsportsKafterKsurgery
B. PresenceKofKaK270°KlabralKtear
C. 2-cmK“on-track”KHill-SachsKlesion
Sports Medicine Scored and Recorded Self-Assessment Examination 2026
,Question 1 of 100
Based on the injury shown on the axial MRI scan of the shoulder in Figure 1, what other pathology
should be closely examined for during surgery?
Figure 1
A. Subscapularis tear
B. Supraspinatus tear
C. Superior labral anterior-posterior (SLAP) tear
D. Bankart tear
Correct answer: A
• Discussion
The axial MRI scan reveals a subluxated biceps tendon. In the study by Koh and associates, 85% of
patients with a biceps subluxation on MRI were found to have a subscapularis tear at the time of
arthroscopy. These are not always obvious on the MRI, and close inspection of the leading edge/upper
border of the subscapularis tendon at the time of arthroscopy is necessary. Although supraspinatus
tears, SLAP tears, and Bankart tears can all occur in conjunction with a biceps subluxation, none have
been shown to be strongly correlated with this pathology, nor as specific to this pathology.
• Recommended Readings
,Shi LL, Mullen MG, Freehill MT, Lin A, Warner JJ, Higgins LD. Accuracy of long head of the
biceps subluxation as a predictor for subscapularis tears. Arthroscopy. 2015 Apr;31(4):615-9.
doi: 10.1016/j.arthro.2014.11.034. Epub 2015 Jan 28. PubMed
Koh KH, Kim SC, Yoo JC. Arthroscopic Evaluation of Subluxation of the Long Head of the
Biceps Tendon and Its Relationship with Subscapularis Tears. Clin Orthop Surg. 2017
Sep;9(3):332-339. doi: 10.4055/cios.2017.9.3.332. Epub 2017 Aug 4. PubMed
Question 2 of 100
Figure 1 is the radiograph of a 31-year-old man who had left shoulder pain after a fall during a
snowboarding jump. Residual displacement of 5 mm after closed reduction is most likely to result in
Figure 1
A. nonunion.
B. osteonecrosis.
C. altered rotator cuff mechanics.
D. normal shoulder function.
, CorrectKanswer:KC
• Discussion
HumerusKfracturesKaccountKforK11%KofKallKfracturesKamongKsnowboardersKandKareKtheKsecond-most-
KcommonKupper-
extremityKfractureKafterKradiusKfracturesK(48%).KSurgicalKfixationKisKrecommendedKforKfracturesKwithKresi
dualKdisplacementK>5Kmm,KorK>3KmmKinKactiveKpatientsKinvolvedKinKfrequentKoverheadKactivity.KMalunion
KcanKresultKinKaKmechanicalKblockKtoKshoulderKabductionKorKexternalKrotationKandKalteredKrotatorKcuffKme
chanics,KcausingKweakness.KAKrichKarterialKnetworkKprovidesKaKfavorableKhealingKenvironmentKforKgreate
rKtuberosityKfractures.KConsequently,KnonunionKandKosteonecrosisKareKuncommon.
• RecommendedKReadings
BissellKBT,KJohnsonKRJ,KShafritzKAB,KChaseKDC,KEttlingerKCF.KEpidemiologyKandKriskKfactorsK
ofKhumerusKfracturesKamongKskiersKandKsnowboarders.KAmKJKSportsKMed.K2008KOct;36(10):188
0-8.KEpubK2008KJulK1.KPubMed
GeorgeKMS.KFracturesKofKtheKgreaterKtuberosityKofKtheKhumerus.KJKAmKAcadKOrthopKSurg.K200
7KOct;15(10):607-13.KFullKtext
Question 3 of 100
K K K
AK23-year-
oldKstudentKcomplainsKofKrecurrentKleftKshoulderKinstability.KHeKfirstKdislocatedKhisKshoulderKinKhighKscho
olKwhileKplayingKlacrosseKandKwasKmanagedKwithKphysicalKtherapy.KAKsecondKdislocationKoccurredKoneKye
arKlaterKwhileKskiing.KHeKhasKsinceKsustainedKtwoKmoreKdislocationsKandKsaysKthatKhisKshoulderKfeelsK“loo
se.”KExaminationKrevealsKgradeKIIKanteriorKloadKandKshift,KpositiveKapprehensionKandKrelocationKtests,Kan
dKnormalKrotatorKcuffKstrength.KAnKMRIKarthrogramKisKorderedKandKsurgicalKtreatmentKisKrecommended.K
WhatKfactorKwouldKmostKstronglyKrepresentKanKindicationKforKaKprocedureKincludingKboneKaugmentation
K(e.g.KLatarjet)KratherKthanKaKsoft-tissue-onlyKstabilizationK(isolatedKlabralKrepair/capsulorrhaphy)?
A. Patient’sKintentionKtoKresumeKlacrosseKandKotherKcontactKsportsKafterKsurgery
B. PresenceKofKaK270°KlabralKtear
C. 2-cmK“on-track”KHill-SachsKlesion
