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This is because cartilage lacks its own blood supply, relying instead on diffusion from surrounding synovial fluid for nutrient delivery

Monitoring and follow-up Monitor clinically and repeat tests as indicated by the underlying condition Ongoing monitoring of liver function, renal function, and FBC as clinically indicated Regular review in primary care or specialist clinics for underlying conditions Patient advice: Patients should understand that elevated B12 is a marker requiring investigation rather than a condition requiring direct treatment

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10.1093/jpp/rgaa048 157 SanjayS.GirishC.ToiP

Early signs include pain while gripping objects, weakness in the hand, discomfort while using a mouse or lifting light items, and tenderness on the outer elbow