Panner’s disease is avascular necrosis of the capitulum of the distal humerus commonly seen in the age group of 5-11 years.
Most commonly occurs in the dominant elbow
AVN of the capitulum is secondary to trauma
Interferences of blood supply of growing epiphysis of capitulum result in resorption later on repair and replacement of the ossific center.
Etiology
Chronic repetitive trauma to the elbow
Congenital and hereditary factors
Embolism
Endocrine disturbances
Differential diagnosis of Panner’s disease
Osteochondritis dessicans
- Seen in adolescent boys
- Related to throwing injury
Clinical features
The followings are the common presentation of panner’s elbow:
- Intermittent pain/stiffness of the affected elbow
- Tenderness at capitulum
- Slight effusion
- Synovial thickening
- Limited extension, lacks 20-30 degrees of extension
- Slight loss of pronation/ supination with tenderness
Radiological Features and Changes of Panner’s disease
Irregular capitulum and radiolucency followed by sclerosis
In 3-5 months: Larger radiolucent area and reconstruction of bony epiphysis
In 1-3 years: Epiphysis returns to normal configuration
In 50% of cases: The radial head shows early maturation compared to normal
Treatment
Symptomatic relief
Epiphysis becomes revascularized and develops normal configuration
Long Arm Cast/ Slab: If pain is severe (To decrease elbow activity)
