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10.1016/j.jmb.2011.11.006 320 YuyamaK.YanagisawaK

Dysbiosis of the duodenal mucosal microbiota is associated with increased small intestinal permeability in chronic liver disease

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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]