Patient case (clinical description): A 47-year-old woman comes to the office complaining of pain in the calf and knee when she bends down. The pain limits her activity. Her medical history is significant for osteoarthritis, for which she uses nonsteroidal anti-inflammatory drugs (NSAIDs) for the past two years. She is living with her husband and has 3 children. She doesn't smoke but drinks alcohol occasionally. Her vital signs are normal. On physical examination, there is a small effusion in the right knee. The effusion grew a little larger and she developed a tender swelling in the popliteal fossa and calf. Both the pain and swelling worsened as she bent and straightened her knee.

Patient's own account: I'm a 47-year-old woman, married with 3 kids. I don't smoke and I drink occasionally. I went to the doctor because of pain in my calf and knee when I was bending down. This has been limiting my daily activities. I have been diagnosed with osteoarthritis for which I have taken anti-inflammatory drugs for the past 2 years. The doctor saw a small fluid buildup in my right knee. This buildup became a bit bigger and I have a swollen calf. The pain is worse when I bend and straighten my knee.

Clinical trial: Ultrasound and Exercises in Knee Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

        To be included in the study, participants needed to suffer knee osteoarthritis with
        osteoarthritis levels 2 - 4 according to Kellgren-Lawrence grade12, be aged between 50 and
        75 years and suffer knee pain and functional disability for at least three months,
        according to the criteria of the American College for Rheumatology (ACR)13. Participants
        from both genders were included. The Kellgren and Lawrence grading of knee osteoarthritis
        is as follows: none (0), doubtful (1), minimal (2), moderate (3) and severe (4).

        The ACR criteria of knee osteoarthritis are as follows:

          -  Using history and physical examination: knee pain and three of the following - over 50
             years old; less than 30 minutes of morning stiffness; bone tenderness; bone
             enlargement; no palpable warmth of synovial.

          -  Using history, physical examination and radiographic findings: knee pain and one of
             the following - over 50 years old; less than 30 minutes of morning stiffness; crepitus
             on active motion; and osteophytes.

          -  Using history, physical examination and laboratory findings: knee pain and five of the
             following - over 50 years old; less than 30 minutes of morning stiffness; bone
             tenderness; bone enlargement; no palpable warmth of synovial; crepitus on active
             motion; ESR <40 mm/h; rheumatoid factor <1: 40; synovial fluid sign of osteoarthritis.

        Exclusion Criteria:

          -  Participants were excluded if they had cancer, diabetes, symptomatic hip
             osteoarthritis, or used antidepressants, anti-inflammatory medications or anxiolytics
             during six months prior to enrollment.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 50 Years old.
Subject must be at most 75 Years

Eligibility (NLI label): Contradiction