CCSP Sports Injury Diagnosis 3 — Questions and Answers
Question 1: A football lineman experiences acute knee pain and swelling after a valgus force with the foot planted. Lachman test is positive but valgus stress test is negative. What is the isolated injury?
- Medial collateral ligament
- Anterior cruciate ligament (Correct answer)
- Posterior cruciate ligament
- Lateral collateral ligament
Correct answer: Anterior cruciate ligament
A positive Lachman test with negative valgus stress test indicates an isolated ACL injury without MCL involvement.
Question 2: Which special test is used to detect a SLAP (superior labrum anterior to posterior) lesion in a throwing athlete?
- Neer impingement sign
- O'Brien active compression test (Correct answer)
- Hawkins-Kennedy test
- Speed's test
Correct answer: O'Brien active compression test
The O'Brien active compression test (with pain in adduction/internal rotation relieved by supination) is the most sensitive clinical test for SLAP lesions.
Question 3: A cross-country runner develops insidious anterior shin pain that is worse with activity and better with rest. Point tenderness is found over the medial tibial cortex. The most likely diagnosis is:
- Chronic exertional compartment syndrome
- Tibial stress fracture
- Medial tibial stress syndrome (Correct answer)
- Popliteal artery entrapment
Correct answer: Medial tibial stress syndrome
Diffuse posteromedial tibial tenderness along the distal two-thirds of the tibia in a runner is the hallmark of medial tibial stress syndrome (shin splints).
Question 4: A wrestler presents with severe ear pain and a fluctuant, non-tender swelling of the auricle after repeated blunt trauma. What is the correct immediate management?
- Ice and compression wrap
- Aspiration and pressure dressing (Correct answer)
- Oral antibiotics and observation
- Surgical excision
Correct answer: Aspiration and pressure dressing
Auricular hematoma (cauliflower ear) requires prompt aspiration and application of a pressure dressing to prevent cartilage necrosis and permanent deformity.
Question 5: A cyclist describes pain in the lateral thigh and buttock that radiates below the knee after long rides. The piriformis stretch reproduces symptoms. The most likely diagnosis is:
- L4-L5 disc herniation
- Piriformis syndrome (Correct answer)
- Sacroiliac joint dysfunction
- Greater trochanteric bursitis
Correct answer: Piriformis syndrome
Piriformis syndrome involves sciatic nerve compression by the piriformis muscle, producing buttock and posterior thigh/leg pain reproduced by piriformis stretching.
Question 6: In a skier who falls forward with the ski fixed, a 'dashboard' mechanism injures which knee structure most commonly?
- Anterior cruciate ligament
- Posterior cruciate ligament (Correct answer)
- Medial meniscus
- Popliteofibular ligament
Correct answer: Posterior cruciate ligament
A posteriorly directed force on the proximal tibia (dashboard mechanism or forward fall with fixed ski boot) most commonly injures the posterior cruciate ligament.
Question 7: A swimmer develops insidious anterior shoulder pain with a painful arc between 60° and 120° of abduction. The Hawkins-Kennedy test is positive. What is the most likely diagnosis?
- Acromioclavicular joint sprain
- Subacromial impingement syndrome (Correct answer)
- Biceps tendon rupture
- Glenohumeral instability
Correct answer: Subacromial impingement syndrome
A positive Hawkins-Kennedy test (internal rotation at 90° flexion) combined with a painful arc is the classic presentation of subacromial impingement syndrome.
CCSP Sports Injury Diagnosis 3
A football lineman experiences acute knee pain and swelling after a valgus force with the foot planted.
Lachman test is positive but valgus stress test is negative.
What is the isolated injury?