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: A Double-Blind, Double Dummy, Randomized Comparison Study Of The Efficacy And Safety Of Valdecoxib 10mg Once Daily And Naproxen 500mg Twice Daily In Treating The Signs And Symptoms Of Osteoarthritis Of The Knee Or Hip In Taiwan

Eligibility criteria:
Inclusion Criteria:

          -  The diagnosis of hip OA, which was having hip pain and meeting criteria for at least 2
             of the following: a. Westergren erythrocyte sedimentation rate of < 20 mm/hr; b.
             radiographic femoral or acetabular osteophytes or c. radiographic joint space
             narrowing

          -  Knee OA diagnosis required diagnosing (by modified American College of Rheumatology
             criteria) OA of the knee with pain plus at least one of the following: a. Age> 50
             years old, b. Stiffness < 30 minutes, c. crepitus on active motion and radiographic
             evidence of OA of the knee, defined as presence of osteophytes or joint space
             narrowing

          -  Symptomatic OA of the knee or hip was determined at the Baseline Visit, if the
             Patient's Assessment of Arthritis Pain was at least 40 mm VAS, Patient's and the
             Physician's Global Assessment of Arthritis was "poor" or "very poor"

        Exclusion Criteria:

          -  Use of NSAIDs or analgesics within 2 days (within 4 days for subjects taking
             oxaprozin, piroxicam or full dose aspirin) before baseline arthritis assessments
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Entailment