Definition
- Osteochondrosis of the entire capitellar ossific nucleus
- Named after Hans Panner, who described it in 1927
- Thought to reflect disordered endochondral ossification with ischaemia of the immature capitellum
Epidemiology
- Boys under 10 years
- Dominant arm, often in throwing sports
- Peak age 7 to 10 years
- Rare and much less common than capitellar osteochondritis dissecans
Clinical Features
- Lateral elbow pain and stiffness, often a loss of extension
- No loose bodies or mechanical symptoms
- Tenderness over the lateral elbow
- Swelling and mild effusion
- Symptoms are often worse after activity
Investigations
- X-ray shows fragmentation, irregularity and sclerosis of the whole capitellum
- MRI if the diagnosis is uncertain
- Compare with the other elbow, as normal ossification can look irregular
- Repeat radiographs show gradual reconstitution over 1 to 2 years
Management
- Rest from throwing and symptomatic care
- Self limiting with reossification and good long term outcome
- Brief splinting for pain
- Avoid throwing and weight bearing on the arm until symptoms settle
- Surgery is not indicated
- Some loss of extension may persist
Differential Diagnosis
| Feature | Panner disease | Osteochondritis dissecans |
|---|---|---|
| Age | Under 10 years | 12 to 16 years |
| Lesion | Whole ossific nucleus | Focal anterolateral lesion |
| Loose bodies | No | Possible |
| Prognosis | Good | Variable |
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.