OCS Sports Medicine & Athletic Injuries 1 — Questions and Answers
Question 1: Which special test is considered most specific for diagnosing an anterior cruciate ligament (ACL) tear?
- Lachman test (Correct answer)
- McMurray test
- Anterior drawer test
- Valgus stress test
Correct answer: Lachman test
The Lachman test is performed at 20-30 degrees of knee flexion and has the highest sensitivity and specificity for ACL tears compared to the anterior drawer test.
Question 2: According to the Ottawa Ankle Rules, which finding indicates the need for ankle radiographs?
- Tenderness along the anterior talofibular ligament
- Inability to bear weight both immediately after injury and in the clinic (Correct answer)
- Tenderness over the Achilles tendon insertion
- Diffuse swelling over the lateral malleolus
Correct answer: Inability to bear weight both immediately after injury and in the clinic
The Ottawa Ankle Rules indicate X-rays are needed if the patient cannot bear weight (4 steps) immediately after injury and in the ED/clinic, or if there is bone tenderness at specific bony landmarks.
Question 3: A baseball pitcher presents with posterior shoulder pain and a clicking sensation during the late cocking phase of throwing. Which condition is most likely?
- Full-thickness rotator cuff tear
- Superior labrum anterior to posterior (SLAP) lesion (Correct answer)
- Acromioclavicular joint sprain
- Subacromial impingement syndrome
Correct answer: Superior labrum anterior to posterior (SLAP) lesion
SLAP lesions commonly occur in overhead athletes due to the traction and compression forces placed on the superior labrum during the late cocking phase of throwing.
Question 4: Which muscle is primarily responsible for dynamic patellar stabilization and is a common focus of rehabilitation for patellofemoral dysfunction?
- Rectus femoris
- Vastus medialis oblique (VMO) (Correct answer)
- Iliotibial band tensor
- Vastus lateralis
Correct answer: Vastus medialis oblique (VMO)
The VMO pulls the patella medially and is critical for dynamic patellar stabilization; weakness relative to the vastus lateralis contributes to lateral patellar tracking dysfunction.
Question 5: A football player sustains a direct blow to the lateral knee with the foot planted. Which ligament is most likely injured by this valgus-producing force?
- Lateral collateral ligament
- Medial collateral ligament (MCL) (Correct answer)
- Posterior cruciate ligament
- Popliteofibular ligament
Correct answer: Medial collateral ligament (MCL)
A direct blow to the lateral knee with the foot planted creates a valgus stress that places the medial collateral ligament under tension, making it the most commonly injured structure.
Question 6: What is the most common mechanism of Achilles tendon rupture in middle-aged recreational athletes?
- Direct blow to the posterior heel during contact sport
- Sudden eccentric load during push-off with the knee extended (Correct answer)
- Forced dorsiflexion upon landing from a jump
- Gradual failure from chronic insertional tendinopathy
Correct answer: Sudden eccentric load during push-off with the knee extended
Achilles tendon ruptures most commonly occur during sudden push-off activities (e.g., lunging in racquet sports) when the gastrocnemius-soleus complex is loaded eccentrically with the knee extended.
Question 7: Which clinical test is the primary assessment for posterior cruciate ligament (PCL) integrity?
- Posterior drawer test (Correct answer)
- Lachman test
- Pivot shift test
- Dial test at 30 degrees
Correct answer: Posterior drawer test
The posterior drawer test, performed with the knee at 90 degrees of flexion, directly stresses the PCL and is the gold standard clinical test for PCL integrity.
OCS Sports Medicine & Athletic Injuries 1
Which special test is considered most specific for diagnosing an anterior cruciate ligament (ACL) tear?