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

Introduction: Osteochondrosis of humeral capitellum (Panner’s disease) is a rare condition. Very few cases are reported in the literature and may be overlooked or misdiagnosed. Most cases are unilateral in distribution and occur in young boys during the first decade of life. It is often difficult to distinguish osteochondrosis from osteochondritis dissecans of the humeral capitellum that occurs in older children and adolescents in the second decade of life. Case Report: We describe a case of a 6-year-old boy who presented with pain, subtle swelling and limited extension in his right elbow following a fall. Diagnosis of Panner’s disease was made 2 weeks later on follow-up based on classical features on plain radiograph of joint effusion, irregular delineation of the articular contour, and faint sclerosis of the capitellum with a radiolucent line in the subchondral bone. The patient had uneventful full functional recovery with conservative treatment: Rest, temporary immobilization, and subsequent remobilization. Conclusion: Osteochondrosis of humeral capitellum though rare is a known condition. It may be overlooked or misdiagnosed. High degree of awareness is required and diagnosis can be made with utmost care based on the age of presentation, clinical signs and clearly recognizable plain radiographic features of joint effusion, irregular articular outline with radiolucent line in subchondral bone and faint sclerosis of capitellum. Keywords: Osteochondrosis, humerus capitellum, Panner’s disease.

History Page: Leaders in MSK Radiology Hans Jessen Panner, 1871–1930

This history page in the series “Leaders in MSK Radiology” is dedicated to the memory and achievements of the Danish radiologist Hans Jessen Panner, whose name is connected to the medical eponym Panner's disease.

Osteochondritis dissecans in adolescence

Osteochondritis dissecans (OD) involves the adolescent radio-capitellar joint and is due to chronic, compressive forces on the capitellum, ultimately causing injuries ranging from an articular cartilage injury to an osteochondral avulsion fracture. Plain films are often negative, while CT, MRI and MR arthrography are the examinations of choice. OD should not be confused with a pseudodefect of the capitellum or Panner's disease. Staging of the lesion is important for its management, which is conservative for stages 1 and 2, while surgery is indicated for stages 3 and 4. Osteoarthritis is a late complication in 50% of patients with advanced disease.