Panner's disease
| Classification according to ICD-10 | |
|---|---|
| M92.0 | Juvenile osteochondrosis of the humerus |
| ICD-10 online (WHO version 2019) | |
Among Crohn Panner ( juvenile osteochondrosis of the capitellum , Panner disease is understood) a bone necrosis of the elbow joint . This occurs mainly in children and adolescents.
etiology
In Panner's disease, avascular necrosis (circulatory disorder) of the epiphysis of the humerus capitulum , a bone belonging to the elbow joint , occurs mostly in childhood . The disease goes through different stages. In addition to overload and repetitive trauma, hormonal disorders are also discussed as causes.
In adolescents, Panner's disease can manifest itself in the form of osteochondrosis dissecans with the development of a free joint body. Some authors expressly differentiate osteochondrosis dissecans from classic Panner's disease.
Complaint picture
The disease leads to stiffness of the joint, which can last for several months. Intermittent pain conditions in the joint also occur, which can improve at rest and intensify under stress.
The course of the disease is chronic and extends over a period of up to three years.
Diagnosis
The physical examination reveals not only tenderness over the radial joint, but also restricted movement even with passive movement; A stretch deficit that can be up to 30 ° is particularly noticeable.
In imaging diagnostics ( X-ray , computed tomography , magnetic resonance tomography ), four stages can be distinguished:
- Stage I: Subchondrally accentuated compaction of the bone ( sclerosis )
- Stage II: loosening of the internal structures near the joint surface (fragmentation)
- Stage III: Bony destruction with size reduction of the epiphysis ( osteolysis )
- Stage IV: regeneration of the epiphysis (repair)
There is a separate staging for osteochondrosis dissecans .
therapy
As a therapeutic measure, exposure to heavy loads, such as B. Throwing Sports. In more stubborn cases, immobilization of the diseased arm for several weeks using a splint can be considered. Symptoms of pain and swelling then usually resolve spontaneously.
The prognosis is good overall. A permanent impairment of the functionality of the elbow joint results only rarely. In the case of an unfavorable course of osteochondrosis dissecans, an operative procedure ( Pridie drilling , removal of free joint bodies) may be necessary.
literature
- Achim Reichelt (Ed.): Orthopädie. Enke, Stuttgart 1993, ISBN 3-432-25201-3 .
- Adam Greenspan: Orthopedic Radiology. A practical approach. 3rd edition. Lippincott Williams & Wilkins, Philadelphia PA et al. 2000, ISBN 0-7817-1589-X .
