Panner's & OCD Power Point
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| Panner's | Osteochondrosis
Degenerative necrosis followed by re-ossification of a primary or secondary growth center
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| Panner's | Cased by abnormal compressive forces across radiocapitellar joint
Boys <10
Unilateral presentation, usually dominant arm
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| 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)
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| Panner's Treatment | Activity Modification;
May require immobilization for a few weeks;
S/sx may last several months, although long-term prognosis is excellent
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| OD | Adolescents >10 yrs;
Avg presentation age 12-17 yrs;
Common in baseball, gymnastics & racquet sports
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| OD | Compression lesion of radiocapitellar joint;
Bony & articular injury to anterolateral capitellum;
Leading cause of permanent elbow disability in young pitching athletes
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| 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
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| OD Results in what? | Formation of loose bodies;
Overgrowth of radial head;
Early arthritic changes
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| OD Symptoms | Insidious onset;
Gradual hx of pain (worse with activity)-better with rest;
Common tenderness over radiocapitellar joint;
Crepitus with sup/pron
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| 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
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| OD Treatment | Dependent on integrity of articular cartilage;
Intact & stable can be treated conservatively;
Activity modification 3-6 wks
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| 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
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| OD Surgical Tx | Failed non-op tx;
Loose bodies with mechanical symptoms or presence of unstable lesions;
Surgery: drilling & fragment fixation
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