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Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Knee weakness. Pain presents when going up and down the stairs, knees give way, knees “lock,” tenderness on infrapatellar fat pad, quadriceps muscle atrophy. The tongue body is pale, coating is thin white, and the pulse is weak.
Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The anterior knee evaluation starts in a long-axis plane, with the probe placed in the midline, immediately superior to the patella (Fig. 3.38a). This enables examination of the quadriceps tendon, suprapatellar fat pad, suprapatellar synovial recess and, immediately superficial to the femur, the pre-femoral fat pad. Still in a long axis, the probe may be moved distally to the patella, to examine the patellar tendon from its origin down to its distal insertion. Deep to the patellar tendon, the infrapatellar fat pad (Hoffa’s fat pad) can be seen. Transverse scans should also be performed, as well as dynamic evaluation (Fig. 3.38b).
The Spleen(SP)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Inferior medial genicular artery: The inferior medial genicular artery participates in the formation of the genicular anastomosis – a network of vessels around the knee. It does so with the help of the other genicular arteries, including the lateral superior, medial superior, and lateral inferior arteries and three additional contributors: the descending genicular branch of the femoral artery, the descending branch of the lateral femoral circumflex artery, and the anterior recurrent branch of the anterior tibial artery. Genicular branches of the popliteal artery also supply the knee joint capsule and the ligaments of the knee. Supplies the patellar tendon, patella, and infrapatellar fat pad. Vessels in the vicinity of SP 9 contribute to the peripatellar anastomatic network (also known as “rete patellae” and the infrapatellar fat pad (of Hoffa).16
Shedding light on experimental intra-articular drugs for treating knee osteoarthritis
Published in Expert Opinion on Investigational Drugs, 2023
Yang Zhao, Qianhua Ou, Yu Cai, Guangfeng Ruan, Yan Zhang, Changhai Ding
Recently, imaging analysis of joint tissues (e.g. cartilage, synovium, fat pads, and subchondral bone et al.) are showing predictive potential for OA. For instance, Ashinsky et al applied T2 maps of cartilage of medial femoral condyle for predicting early symptomatic OA with the help of machine learning algorithms [181]. More recently, Li et al. reported that magnetic resonance imaging (MRI)-based three-dimensional texture of the infrapatellar fat pad was associated with future development of KOA [182]. Furthermore, the phenotypic abilities of imaging analyses are also reported. Lee et al. reported a set of structural phenotypes based on MRI-detected synovitis (inflammatory phenotype), meniscus/cartilage damage (meniscus/cartilage phenotype), bone marrow lesions (subchondral bone phenotype), and osteophytes (hypertrophic phenotype), and the tool was validated to predict the incidence of radiographic OA [183]. These strongly endorsed the importance of imaging analysis in OA research.
Mass Spectrometry-based Biomarkers for Knee Osteoarthritis: A Systematic Review
Published in Expert Review of Proteomics, 2021
Mirella J.J. Haartmans, Kaj S. Emanuel, Gabrielle J.M. Tuijthof, Ron M. A. Heeren, Pieter J. Emans, Berta Cillero-Pastor
The human knee consists of different tissue types and fluids. Both femur and tibia, as well as the patella, are covered with a layer of hyaline cartilage, supporting subtle movement of the knee. Between these layers of cartilage, a thin layer of synovial fluid is lubricating the cartilage surface for smooth movement. Several ligaments, such as the anterior cruciate ligament (ACL), limit these movements, giving the knee its stability. To prevent bone-to-bone friction and absorb some of the impact on the knee, the menisci are located between the edges of the cartilage layers. All these tissues are surrounded by a layer of synovial membrane, the knee capsule. Finally, yet importantly, underneath the patellar ligament, Hoffa’s fat pad (HFP) or the infrapatellar fat pad is located (Figure 1). HFP has been proven an important metabolic organ, involved in OA’s inflammatory response [8,9]. In the OA knee, the cartilage is damaged, synovium thickened and inflamed, and there is more synovial fluid present (Figure 1).
Osteoarthritis and inflammation: a serious disease with overlapping phenotypic patterns
Published in Postgraduate Medicine, 2020
Francis Berenbaum, Chris Walker
There is likely a large degree of interplay between the three key structures (cartilage, bone, and synovium) and the signaling mediators they produce, and different authors have attached varying levels of significance to each of these components, postulating one, or another, as responsible for driving the pathogenesis of the disease. For example, synovitis appears to be a potential predictive factor of structural progression of medial tibiofemoral OA of the knee [29]. The infrapatellar fat pad also has a role in inflammation and the damage associated with OA [30] with infrapatellar fat pad synovitis shown to be a risk factor for the development of incident radiographic knee OA [31]. Synovitis in the infrapatellar fat pad has also been shown to be associated with the severity of pain [12,32] and signal intensity alteration in the infrapatellar fat pad may be predictive of the emergence of OA [33] and of the need for knee replacement during end-stage disease [34]. The degree of synovitis can even be seen to be predictive of cartilage loss in patients without established OA disease, with a longitudinal study of patients without cartilage damage or tibiofemoral radiographic OA suggesting that synovitis is present even before radiographic presentation of the disease manifests [35].