Abstract
PurposeTo determine the most up-to-date theory on the aetiology of Panner’s disease, to form a consensus on the assessment of radiographs and to evaluate clinical outcome in order to summarise the best available evidence for diagnosis and treatment.MethodsA review of studies to date on Panner’s disease. Studies were eligible if: (1) the study provided criteria for defining Panner’s disease in order to eliminate confounding data on other radiographic entities that were mistakenly grouped and presented as Panner’s disease; (2) original data of at least one patient was presented; (3) manuscripts were written in English, German or Dutch; and (4) a full-text article was available. Animal studies, reviews and expert opinions were not included. Because the majority of the studies were case reports, we did not use an overall scoring system to evaluate methodological quality.ResultsTwenty-three articles reporting on Panner’s disease were included. Most cases of Panner’s disease were unilateral in distribution and occurred in boys during the first decade of life. In general, conservative treatment is advised for Panner’s disease. Panner’s disease is a self-limiting disease and the majority of patients heal without clinical impairment.ConclusionsBased on the results of this review, Panner’s disease should be treated conservatively. Uniform names and descriptions of signs on radiographs would help to make the correct diagnosis. Since Panner’s disease is very rare, higher quality studies are not likely to be performed and, thus, this review provides the best level of evidence on the current knowledge about Panner’s disease.
Highlights
Osteochondrosis is a term used to describe more than 50 different conditions affecting the immature skeleton
In 1927, a Danish orthopaedic surgeon, Dr Dane Panner, first described radiographic changes of the capitellum in the young adult, subsequently known as Panner’s disease [2,3,4]. He considered the aetiology of these radiographic changes in the elbow capitellum to be similar to osteochondrosis of the hip epiphysis
Osteochondrosis, defined by irregularity of the humeral capitellum on plain radiographs, occurs shortly after the appearance of the ossific nucleus under 11 years of age, when the cells are considered vulnerable for ischaemia
Summary
Osteochondrosis is a term used to describe more than 50 different conditions affecting the immature skeleton. In 1927, a Danish orthopaedic surgeon, Dr Dane Panner, first described radiographic changes of the capitellum in the young adult, subsequently known as Panner’s disease [2,3,4]. He considered the aetiology of these radiographic changes in the elbow capitellum to be similar to osteochondrosis of the hip epiphysis. Osteochondrosis and osteochondritis dissecans (OCD) are considered different pathologic entities. Osteochondrosis, defined by irregularity of the humeral capitellum on plain radiographs, occurs shortly after the appearance of the ossific nucleus under 11 years of age, when the cells are considered vulnerable for ischaemia. Osteochondrosis and OCD have significant differences in aetiology, treatment and outcome [1]
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