The capitellum is the rounded lateral articular surface of the distal humerus, articulating with the radial head at the radiocapitellar joint. It is entirely covered by hyaline cartilage and has no non-articular posterior surface in the adult (unlike the trochlea). The capitellum is supplied by vessels entering posteriorly, making its anterior articular surface an avascular watershed zone vulnerable to osteochondral injury.
Osteochondritis dissecans (OCD) of the capitellum is the primary capitellar pathology in adolescent overhead athletes (gymnasts, throwers), producing lateral elbow pain and clicking from repetitive radiocapitellar compression loading. MRI demonstrates the OCD lesion with a characteristic fragmented or unstable flap of articular cartilage and subchondral bone. Stable OCD lesions are managed conservatively; unstable lesions require arthroscopic debridement, drilling, or fragment fixation. Panner's disease (osteochondrosis of the entire capitellum) occurs in younger children and is self-limiting.
Repetitive radiocapitellar compression loading in gymnasts produces OCD of the capitellum with anterolateral capitellar fragment instability causing lateral elbow pain and crepitus; MRI demonstrates the OCD fragment and its stability; unstable fragments require arthroscopic reduction and fixation or autograft osteochondral transplantation from the knee.
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