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The major symptoms of fabella syndrome are pain due to a mechanical irritation of local soft tissues during knee extension, causing tension, by pressure from the fabella, on the lateral femoral condyle, regardless of the history of knee surgery [4, 8].
sup][5] Skin grafts often fail because of poor vascularization due to Achilles tendon exposure, and repeated mechanical irritation.
3 Other risk factors include poor oral hygiene, mechanical irritation, chewing of betel quid preparations, lack of vegetables and fruits in diets and seropositivity of human papilloma virus (HPV) subtype 16.
Comment: Persistent mechanical irritation of the nerve root (as seen with degenerated or herniated discs) sets up a series of events that lead to chronic pain, mediated by sensitization of the dorsal roots and dorsal horns in the spinal cord.
Subacromial impingement involves compression or mechanical irritation of the subacromial bursa, supraspinatus tendon, infraspinatus tendon, and/or long head of the biceps tendon between the coracoacromial arch and the humeral head (Figure 2(a)) [22] and is purported to occur at lower humeral elevation angles.