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Before making the diagnosis of PFIC, in the paediatric population, other cholestasis disorders should always be considered in the differential diagnosis, including biliary atresia, choledochal malformations, congenital endocrine disorders, inborn errors of metabolism (mainly during the neonatal period) as well as autoimmune liver diseases, drug-induced cholestasis and other genetic diseases in older children [72]

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In osteoarthritic joints, features of the local microenvironment, such as acidic synovial fluid, accumulation of reactive oxygen species, and elevated expression of matrix metalloproteinases and proinflammatory cytokines, accelerate cartilage degeneration and synovitis (Yao et al., 2023)

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