| Question | Answer |
| Panner's | Osteochondrosis
Degenerative necrosis followed by re-ossification of a primary or secondary growth center |
| Panner's | Cased by abnormal compressive forces across radiocapitellar joint
Boys <10
Unilateral presentation, usually dominant arm |
| Presentation of Panner's | Pain/stiffness for several weeks;
Accompanied with overuse or mild trauma;
Pain worse with activity, better with rest;
Loss of motion common (~20 deg from full ext) |
| Panner's Treatment | Activity Modification;
May require immobilization for a few weeks;
S/sx may last several months, although long-term prognosis is excellent |
| OD | Adolescents >10 yrs;
Avg presentation age 12-17 yrs;
Common in baseball, gymnastics & racquet sports |
| OD | Compression lesion of radiocapitellar joint;
Bony & articular injury to anterolateral capitellum;
Leading cause of permanent elbow disability in young pitching athletes |
| OD | Caused by repetitive chronic impact of radial head vs. capitellum during cocking & acceleration phase of throwing;
Causes circulatory changes radiocapitellar joint;
Aseptic necrosis of radial head |
| OD Results in what? | Formation of loose bodies;
Overgrowth of radial head;
Early arthritic changes |
| OD Symptoms | Insidious onset;
Gradual hx of pain (worse with activity)-better with rest;
Common tenderness over radiocapitellar joint;
Crepitus with sup/pron |
| OD Imaging | Radiographs show focal area of lucency in sub-chondral bone in anterior aspect of capitellum;
Capitellar refraction, radiolucency or flattening of articular cartilage |
| OD Treatment | Dependent on integrity of articular cartilage;
Intact & stable can be treated conservatively;
Activity modification 3-6 wks |
| OD Treatment | After immobilization, motion can begin;
When motion is full, begin isometrics;
Ex's to lateral compartment must be limited;
Gradual return to activity in 3-6 months |
| OD Surgical Tx | Failed non-op tx;
Loose bodies with mechanical symptoms or presence of unstable lesions;
Surgery: drilling & fragment fixation |
