Panner's Disease Occurred in a Five-year-old Child: A Preliminary Case Report

Abstract

Panner's disease, osteonecrosis of the capitellum of the elbow, was first reported by Panner in 1927. The disease occurs mainly in boys between 6 and 15 years old and shows unilateral distribution. Pain, stiffness, localized tenderness over the lateral condyle of the elbow, and decreased range of motion are the typical clinical symptoms. Conservative treatment is generally recommended for patients in the early stage of this disease. A few cases of Panner's disease have been reported and few are related to long-term follow-up results. To the best of our knowledge, all reported cases were over six years. Therefore, we report on a five-year-old boy diagnosed as Panner's disease that showed resorption and regeneration of the humeral capitellum with no limitation of motion over three years.

Osteochondrosis of humeral capitellum though rare is a known condition in young children. High level of awareness is required to adequately diagnose and treat appropriately

“…Although its etiology and pathogenesis are not very well understood, he considered the etiology of these radiographic changes in the capitellum of the humerus to be similar to osteochondrosis of the hip epiphysis (Legg–Calvé–Perthes) described 17 years earlier [ 5 ]. Some author believe that primary etiological factor of the Panner’s disease is an endocrine disturbance causing disordered endochondral ossification while other believes it to be due to overuse and repetitive abnormal valgus compressive forces exerted across the radiocapitellar joint in pediatric elbow causing microvascular trauma leading to possible ischemic injury of capitellum [ 6 ]. However, trochlea is not affected in Panner’s disease though it derives from the same cartilaginous mass as the capitellum [ 7 ].…”