CCSP Sports Injury Diagnosis 4 — Questions and Answers
Question 1: A basketball player sustains a hyperflexion neck injury and reports transient bilateral arm tingling that resolved within minutes. No neurological deficits remain. This presentation is most consistent with:
- Cervical disc herniation
- Cervical cord neuropraxia (stinger/burner) (Correct answer)
- Transient ischemic attack
- Central cord syndrome
Correct answer: Cervical cord neuropraxia (stinger/burner)
Transient bilateral upper extremity paresthesias following a cervical compression-flexion injury that fully resolve are characteristic of cervical cord neuropraxia.
Question 2: The 'terrible triad' of the elbow refers to which combination of injuries?
- Radial head fracture, coronoid fracture, and medial epicondyle avulsion
- Posterior elbow dislocation, radial head fracture, and coronoid fracture (Correct answer)
- Olecranon fracture, UCL tear, and radial head fracture
- Posterior dislocation, UCL tear, and lateral epicondyle avulsion
Correct answer: Posterior elbow dislocation, radial head fracture, and coronoid fracture
The terrible triad of the elbow consists of posterior dislocation combined with fractures of both the radial head and coronoid process, resulting in gross instability.
Question 3: A golfer presents with medial elbow pain reproduced by resisted wrist flexion and forearm pronation. The diagnosis is:
- Lateral epicondylitis
- Medial epicondylitis (Correct answer)
- Cubital tunnel syndrome
- Pronator teres syndrome
Correct answer: Medial epicondylitis
Medial epicondylitis (golfer's elbow) involves the flexor-pronator tendon origin and is reproduced by resisted wrist flexion and forearm pronation.
Question 4: A track athlete develops exertional lower leg pain relieved only by rest and has increased compartment pressure measured at 15 mmHg at rest and 35 mmHg five minutes post-exercise. The diagnosis is:
- Medial tibial stress syndrome
- Deep vein thrombosis
- Chronic exertional compartment syndrome (Correct answer)
- Tibial stress fracture
Correct answer: Chronic exertional compartment syndrome
Chronic exertional compartment syndrome is diagnosed by post-exercise compartment pressures ≥30 mmHg at 1 minute or ≥20 mmHg at 5 minutes post-exercise.
Question 5: A field hockey player sustains a direct blow to the lateral thigh, resulting in immediate pain, swelling, and a firm mass over the quadriceps. The immediate management priority is:
- Aspiration of the hematoma
- Stretching and range of motion exercises
- RICE with knee in flexion to limit hematoma expansion (Correct answer)
- MRI to rule out myositis ossificans
Correct answer: RICE with knee in flexion to limit hematoma expansion
Acute quadriceps contusion should be managed with RICE and the knee placed in flexion (120°) to limit hematoma formation and reduce risk of myositis ossificans.
Question 6: Which clinical finding best differentiates a complete Achilles tendon rupture from a partial tear?
- Positive Homan's sign
- Positive Thompson (Simmonds) test (Correct answer)
- Tenderness 2-6 cm above the calcaneal insertion
- Swelling and ecchymosis over the posterior heel
Correct answer: Positive Thompson (Simmonds) test
A positive Thompson test (absence of plantarflexion when the calf is squeezed with the patient prone) confirms complete Achilles tendon rupture.
Question 7: A high school wrestler presents with a swollen, red, warm knee effusion 48 hours after a skin abrasion near the joint. The most critical next step is:
- Ice and NSAIDs and follow-up in one week
- Aspiration of the joint and synovial fluid analysis (Correct answer)
- MRI of the knee to evaluate for ligament injury
- Oral antibiotics empirically without aspiration
Correct answer: Aspiration of the joint and synovial fluid analysis
A hot, red effusion following skin trauma raises concern for septic arthritis, which requires immediate joint aspiration and synovial fluid analysis to guide treatment.
CCSP Sports Injury Diagnosis 4
A basketball player sustains a hyperflexion neck injury and reports transient bilateral arm tingling that resolved within minutes.
No neurological deficits remain.
This presentation is most consistent with: