Think beyond tuberculosis: It can be Panner's disease in the child's elbow

Abstract

Panner's disease also known as osteochondrosis of capitellum, is a rare disorder. We present a case of Panner's disease in an 11-year-old male child who was misdiagnosed as tuberculosis on clinical and radiological findings. The duration of symptoms was over 5 months, yet the child retained most of the elbow range of motion. He reported a sharp pain over the lateral condyle during end range of pronation and deep palpation. Plain radiograph findings were contour irregularities and flattening of the articular surface in humeral capitellum. Magnetic resonance imaging T2 images showed decreased signal intensity in capitellum as well as a high signal in joint space consistent with joint effusion. The joint aspirated clear synovial fluid with no culture growth. The outcome of Panner's disease was good with conservative treatment. Panner's disease is often misdiagnosed in our tubercular endemic regions and thus, awareness on the part of the clinician is must.

Keywords

• elbow
• osteochondritis dissecans
• osteochondrosis
• panner's disease
• tuberculosis