Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

Clinical trial: Ketorolac Versus Triamcinolone Knee Injections for Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

          -  Subject must be at least 18 years of age and no older than 90 years of age; of either
             gender

          -  Radiographic evidence of symptomatic osteoarthritis in one or bilateral knees.
             Osteoarthritis will be defined as pain with weight-bearing at the tibiofemoral and/or
             patellofemoral articulation together with radiographic findings as described below.

        At the painful articulation, radiographic evidence of Kellgren-Lawrence

          -  Grade 2: definite osteophytes and possible narrowing of joint cartilage associated
             with sclerosis of subchondral bone or,

          -  Grade 3: moderate multiple osteophytes, definite narrowing of the joint space, small
             pseudocystic areas with sclerotic walls in the subchondral bone, possible deformity of
             bone ends or,

          -  Grade 4: large osteophytes, marked narrowing of joint space, severe sclerosis and
             altered shape of the bone ends.

        Subject agrees to participate in follow-up evaluations and complete outcome score sheets
        (post-injection, 2 weeks, 6 weeks, 3 months and 6 months).

        Exclusion Criteria:

          -  Any inflammatory or neuropathic arthropathy

          -  Insufficiency of the collateral ligaments or cruciate ligaments

          -  Current infection

          -  Recent injection (<3 months)

          -  Pregnant/lactating (β-human chorionic gonadotropin pregnancy test will be completed
             prior to injection)

          -  Allergy or hypersensitivity to the study medications

          -  Currently taking any anti-coagulation medications

          -  Subject is unable to make his/her own decision regarding the informed consent

          -  Subject is unable to read/understand English
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 18 Years old.
Subject must be at most 90 Years

Eligibility (NLI label): Entailment