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I must be getting old, Physical Examination, Synovial aspiration, Onset …

- - - - Presenting symptom
        
        Deep throbbing pain in right knee
        
        Swelling and tenderness of right knee
      - Chondrocyte differentiation into hypertrophic phenotype
        
        Early: increased secretion of ADAMTS leading to aggrecan degradation
        Late: increased secretion of MMPs leading to irreversible type II collagen destruction
        
        Collagen antigens initiates immune response
        
        innate immune activation through TLR-2/4: macrophages release IL-1, IL-6, TNF
        
        NALP-3 inflammasome formation - release IL-1beta, IL-18
        
        Synoviocytes - release IL-1, IL-8
        
        Synovitis
      - Converted to intracellular signals
        
        Activation of NFkB and MAPK pathways
        
        Inflammation - prostaglandins, cytokines