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: Intraarticular Opioids Vs Glucocorticosteroids in Gonarthritis

Eligibility criteria:
Inclusion Criteria:

          -  Arthritis according to the American Rheumatism Association or osteoarthritis of the
             knee

          -  age older than 18 years

          -  active gonarthritis in the setting of a rheumatic inflammatory disease such as
             rheumatoid arthritis, spondyloarthropathies, undifferentiated oligoarthritis or
             monarthritis since at least 4 weeks with proof of joint or ostearthritis of the knee
             effusion in ultrasound

          -  visual analogue scale (pain) >30 mm

          -  weight between 50 and 90 kg

          -  signed informed consent

          -  negative urine pregnancy test in women of child-bearing potential

        Exclusion Criteria:

          -  pregnancy / lactation

          -  severe infection, suspicion for opportunistic infection within the last 2 months
             (herpes zoster, cytomegaly-, pneumocystis carinii-infection), HIV- infection

          -  malignant disease

          -  severe cardiac, renal, hematologic, pulmonary, neurologic, gastrointestinal (amongst
             others gastric or duodenal ulcer) or hepatic (viral hepatitis, toxic liver disease
             etc) disease, uncontrolled high blood pressure, recurrent thrombosis/ embolism

          -  psychiatric disease

          -  significant bone marrow dysfunction with impaired hematopoiesis

          -  one of the following laboratory findings: thrombocytopenia < 100 /nl, Quick < 50%

          -  significant pathological findings in physical examination, especially findings
             indicating an infectious cause for arthritis (septic arthritis) or Lyme arthritis

          -  participation in clinical trials within the last 30 days

          -  intake of illegal drugs (such as cocaine, heroin...), substance abuse (alcohol,
             excessive intake of analgetic drugs, benzodiazepines)

          -  intake of anticoagulating drugs
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 19 Years old.


Eligibility (NLI label): Contradiction