CCSP - Certified Chiropractic Sports Physician Sports Injury Diagnosis Questions and Answers

Question 1

A 19-year-old soccer player presents with acute knee pain after a valgus force and external rotation of the tibia while their foot was planted. The athlete reports hearing a 'pop' and describes significant swelling and instability. Based on this mechanism of injury, which combination of structures, known as the 'unhappy triad,' is most likely injured?

Accepted Answer

Anterior cruciate ligament, medial collateral ligament, and medial meniscus

Answer

The 'unhappy triad,' or O'Donoghue's triad, classically involves injury to the anterior cruciate ligament (ACL), medial collateral ligament (MCL), and the medial meniscus. [4, 6, 7] This combination of injuries typically results from a valgus force applied to the knee, often combined with tibial external rotation, a common mechanism in contact sports. [4, 6]

Question 2

A 14-year-old gymnast presents with severe wrist pain after a fall onto an outstretched hand. Radiographs reveal a fracture that extends through the physis (growth plate) and exits through the metaphysis. According to the Salter-Harris classification, what type of fracture is this?

Accepted Answer

Type II

Answer

A Salter-Harris Type II fracture is the most common type and involves a fracture line that runs across the physis and then exits through the metaphysis, creating a triangular metaphyseal fragment (the Thurston-Holland fragment). [2, 3, 9] Type I is a slip through the physis, Type III is an intra-articular fracture through the epiphysis and physis, and Type IV goes through the epiphysis, physis, and metaphysis. [3, 8, 9]

Question 3

A 28-year-old baseball pitcher complains of deep, anterior shoulder pain and a 'clicking' sensation during the late cocking phase of throwing. Which of the following orthopedic tests is most specific for diagnosing a Superior Labral Anterior-Posterior (SLAP) lesion?

Accepted Answer

Biceps Load II Test

Answer

The Biceps Load II Test is a highly specific clinical test for diagnosing SLAP lesions, particularly Type II. [5, 23] The test is performed with the patient supine, the shoulder abducted to 120 degrees and externally rotated, and the elbow flexed to 90 degrees. Pain with resisted elbow flexion indicates a positive test. [5, 23] Neer's and Hawkins-Kennedy are primarily for impingement, and the Empty Can test assesses the supraspinatus.

Question 4

A track and field sprinter pulls up suddenly during a 100-meter dash, grabbing the back of their thigh. They report a sharp, tearing sensation. A clinical examination reveals significant ecchymosis, a palpable defect in the hamstring muscle belly, and a considerable loss of strength in knee flexion. What is the most appropriate grade for this muscle strain?

Accepted Answer

Grade III

Answer

This presentation is characteristic of a Grade III muscle strain, which involves a complete rupture of the muscle. [14, 15, 17] Key clinical findings include a palpable defect, severe pain, extensive bruising (ecchymosis), and a complete or near-complete loss of function and strength. [15, 17] Grade I involves microscopic tearing, and Grade II is a partial tear with moderate strength loss. [14, 15] Grade IV is not a standard part of the traditional 3-grade clinical system but is used in some imaging-based classifications. [21]

Question 5

Which of the following findings would mandate immediate referral for ankle radiographs according to the Ottawa Ankle Rules?

Accepted Answer

Inability to bear weight for four consecutive steps immediately after the injury and in the clinic

Answer

The Ottawa Ankle Rules are a clinical decision tool to determine the need for X-rays. One of the key criteria is the inability to bear weight both immediately after the injury and for four steps during the examination. [25, 31, 32] The other criteria include bony tenderness at specific locations (posterior edge of medial or lateral malleolus, base of the 5th metatarsal, or navicular). [25, 32] Swelling, pain level, and ligamentous laxity alone are not criteria that mandate radiography according to these rules. [31]

(CCSP) Certified Chiropractic Sports Physician Practice Test

(CCSP) Certified Chiropractic Sports Physician Practice Test

CCSP - Certified Chiropractic Sports Physician Sports Injury Diagnosis Questions and Answers