radiolucency. Treatment is symptomatic, with a good prognosis. Treatment is minimal and includes restricting athletic activity to allow for the elbow to heal and for pain to be relieved.[4] The disease is named after the Danish radiologist Hans Jessen Panner
(1871–1930).
Symptoms
An individual with Panner disease most commonly experiences elbow pain near the capitellum.[2] Other symptoms include:
These symptoms worsen with physical activity such a throwing a ball or gymnastics for example. The symptoms begin unexpectedly and are often present for several days or weeks, and the symptoms tend to last even longer.[2]
Causes
Being an extremely
growth plate of the capitellum die and it becomes flat due to the softening and collapsing of the surrounding bone.[citation needed
]
Mechanism
The capitellum is the rounded knob on the end of the humerus, and it is held by the radius.
Panner Disease affects the
growth plate. The bone's growth plate is defined as the area at the end of a developing bone where cartilage cells change into bone cells.[6] The bone tissue does regrow, but the necrosis can cause temporary problems in the affected area until the strenuous arm and elbow activity is significantly decreased or stopped for a period of time.[6]
It is believed that Panner Disease is a precursor to a similar condition called osteochondritis dissecans of the capitellum (OCD).[6] OCD is different from Panner disease because OCD occurs in older children and it does not involve the growth plate because by the time that OCD occurs the growth plates have already fused and the skeleton has finished growing.[citation needed]
Diagnosis
As the symptoms become prominent, the child will visit their
family doctor to confirm whether or not the child has Panner Disease. When the child visits the doctor, the doctor will seek information about the child's age, sports participation, activity level, and what the child's dominant arm is. The affected elbow will be compared to the healthy elbow and any differences between the two will be noted.[5] The location of where the pain is in the elbow, and the child's range of motion and extension will also be determined to make an accurate diagnosis. To check the child's range of motion and extension limitation the child will be asked to move the arm of the affected elbow in various directions. The movement of the arm in various directions will allow the doctor to conclude how good the child is able to move the arm and the doctor will be able to determine if there is pain caused by the various directions of movement.[5]
To prevent future instances of Panner Disease the child is instructed to cease all physical and sports activities that involve the use of the affected elbow until the symptoms are relieved[citation needed]
Treatment
The goal of treatment in Panner disease is to relieve
acetaminophen to also reduce pain and swelling.[4]
Prognosis
For treatment, Panner Disease heals well in children with rest and restriction of
physical activity and sports using the affected arm. The prognosis is also good with treatment and the affected capitellum is remodeled. Irregularities of the capitellum and surrounding elbow area can both be seen by radiograph and MRI. When treatment is effective the flattened and fragmented capitellum is completely remodeled and returns to its normal circular shape, and also the high intensity signal on an MRI T2 series disappears.[5] These results indicate that the capitellum is completely remodeled and the child is able to return to normal physical and sports activities.[citation needed
]
Research
Although the exact cause of Panner Disease is unknown, in recent research, it has been concluded that it may be associated with frequent throwing or other athletic activity.
swelling, limited range of motion, and limited elbow extension.[2] In alignment with the previously mentioned article, the team of researchers also concluded that Panner Disease involves irregularity of the capitellum, specifically that it appears flattened. Panner Disease often gets misdiagnosed as osteochondritis dissecans (OCD), and in this article they distinguish the difference between the two diseases are age difference and radiographic findings.[2] In alignment with the two previously discussed articles, another article that reports on three case studies of Panner Disease, states that the primary treatment that is used for Panner Disease is rest and restriction from all physical and athletic activity that involves the use of the upper extremities; the activity is suggested to be ceased until the symptoms are relieved.[5]
References
^RESERVED, INSERM US14 -- ALL RIGHTS. "Orphanet: Panner disease". www.orpha.net. Retrieved 15 September 2017.{{cite web}}: CS1 maint: numeric names: authors list (link)
