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Orthopaedics · Shoulder injuries
Sample itemAfter a direct fall onto the point of the shoulder, a patient has a visible step deformity above the lateral clavicle. Which injury is most likely?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Acromioclavicular joint separation
A direct impact on the shoulder can disrupt the acromioclavicular and coracoclavicular ligaments, allowing the distal clavicle to become prominent and creating a step deformity.
Option by option
A. Acromioclavicular joint separation (correct)
Correct: AC separation produces clavicular prominence after a shoulder-point impact.
B. Proximal humerus fracture
Proximal humerus fractures usually cause marked pain and bruising around the upper arm.
C. Rotator cuff tear
Rotator cuff tears cause weakness and painful arcs rather than a clavicular step.
D. Adhesive capsulitis
Adhesive capsulitis causes gradual global stiffness without acute deformity.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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