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The condition is more prevalent in males and presents as insidious onset pain at the proximal insertion site of the quadriceps tendon over the patella (20% of cases), pain at the inferior pole of the patella (70% of cases), or less commonly, pain at the tibial tuberosity (10%), which may increase during physical activity and digital pressure [4,5,6]
(4) inflammation and immunomodulation pathways (e.g., NF-B signaling, NOD-like receptor pathways, cytokine-cytokine receptor interaction)