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Panner's Disease

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Panner's Disease

Elliot K. Fishman, MD
Director of Diagnostic Imaging and Body CT, Professor of Radiology and Radiological Science, Johns Hopkins
Karen M. Horton, MD
Professor and Interim Chair, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins
 
 

This is a young patient who presents with lateral elbow pain over the last 3 months. Frontal and lateral radiographs of the elbow were obtained. The frontal radiograph demonstrates an irregular appearance of the capitellum as indicated by the red arrow. The capitellum appears flattened with a mixed lytic and sclerotic appearance. These same findings are also nicely seen on the lateral radiograph as identified by the red arrow. The abnormality involves the entirety of the capitellum. No loose body within the elbow joint is appreciated. These findings are most consistent with an osteochondrosis of the capitellum, also known as Panner's Disease. Panner's disease most commonly occurs in young patients between the ages of 8-12. It is secondary to overuse, and is commonly seen in children who participate in little league baseball or softball. This osteochondrosis will resolve on its own with rest and symptom management. It is important to distinguish this disease from osteochondritis dessicans of the capitellum, which may also occur in children who play baseball or softball. However, as opposed to Panner's disease, osteochondiritis dessicans usually affects older adolescenets, does not involve the entirety of the capitellum, and is associated with loose bodies. It is also not a self-limiting disease process. These clinicial and imaging features help to distinguish the two disease processes.