Panner's disease

Panner's Disease is a rare condition affecting the elbow joint, primarily seen in children and adolescents. It is characterized by a localized loss of blood supply (avascular necrosis) to the capitellum of the humerus, leading to the fragmentation and eventual healing of the bone. This condition is often confused with osteochondritis dissecans, another joint condition, but they are distinct in their clinical presentation and management.

Causes and Risk Factors

The exact cause of Panner's Disease remains unclear, but it is thought to be related to disruption of blood supply to the capitellum. Several factors may contribute to this disruption, including:

• Repetitive stress or trauma to the elbow, common in young athletes participating in sports that involve throwing or gymnastics.
• Genetic predisposition, although specific genetic markers have not been identified.
• Rapid growth periods in children, which might affect blood supply to the growing bones.

Symptoms

Individuals with Panner's Disease typically present with:

• Pain in the affected elbow, especially with movement.
• Swelling and tenderness around the elbow.
• Limited range of motion in the elbow joint.
• Stiffness in the elbow, particularly in the morning.

Diagnosis

Diagnosis of Panner's Disease involves a combination of clinical examination and imaging studies. Key diagnostic tools include:

• X-ray: May show changes in the capitellum, including fragmentation or flattening.
• Magnetic Resonance Imaging (MRI): Provides detailed images of the elbow's soft tissues and can help differentiate Panner's Disease from other conditions.

Treatment

Treatment of Panner's Disease is primarily conservative, focusing on relieving symptoms and promoting healing of the affected bone. Treatment strategies include:

• Rest and avoidance of activities that exacerbate symptoms.
• Application of ice to reduce swelling.
• Non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain.
• Physical therapy to maintain range of motion and strengthen surrounding muscles.

In most cases, Panner's Disease resolves spontaneously over time as the child grows, and the blood supply to the capitellum is restored. Surgical intervention is rarely required but may be considered in severe cases that do not respond to conservative management.

Prognosis

The prognosis for Panner's Disease is generally excellent, with most individuals achieving full recovery without long-term complications. However, it is crucial for the condition to be properly managed to prevent permanent damage to the elbow joint.

Prevention

Preventive measures for Panner's Disease are not well-defined due to the unclear etiology of the condition. However, minimizing repetitive stress on the elbow, especially in young athletes, may help reduce the risk of developing the condition.