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: Effects on the Pain of an Infiltration by Acid Hyaluronic Association and Corticoids Versus Only Corticoids in the Rhizarthrosis.

Eligibility criteria:
Inclusion Criteria:

          -  Adults, ≥ 40 years

          -  Pain located at the root of the thumb (near the wrist) and awakened by direct pressure
             and movement

          -  Pain resistant to well-conducted medical treatment, with analgesics, NSAIDs, icing
             with pain (analog visual scale) ≥ 4 for more than 3 months

          -  Radiological findings (kapandji face + profile incidence) typical of rhizarthrosis,
             stage II or III of Eaton and Litter, with at least 2 of the following 5 radiological
             elements observed on the trapeziometacarpal joint:

               -  marginal osteophyte

               -  pinching of the joint space

               -  sclerosis of the subchondral space

               -  subchondral kyst

               -  absence of osteopenia

          -  Patient with the ability to understand the protocol and signed informed consent

          -  Patient receiving social security

        Exclusion Criteria:

          -  Known allergy to any of the products (corticosteroids or hyaluronic acid) including
             its excipients (methyl parahydroxybenzoate, propyl parahydroxybenzoate, benzyl
             alcohol)

          -  Change of analgesic treatment within 4 weeks before inclusion.

          -  Patients with symptomatic bilateral rhizarthrosis

          -  Scaphoid-trapezial arthrosis

          -  Local or general infection

          -  Severe coagulation disorders, ongoing anticoagulant therapy

          -  severe and / or uncontrolled hypertension

          -  Earlier local surgery

          -  Associated inflammatory rheumatism

          -  Tendinopathy of De Quervain, thumb to jump associated

          -  Infiltrations earlier than 6 months

          -  Diabetes imbalanced

          -  Live vaccines

          -  Severe water and / or sodium retention (hypernatremia), particularly in cases of heart
             failure, decompensated liver failure (edema and ascites failure)

          -  Pregnant or lactating women

          -  Immunocompromised or hemodialysis patients

          -  Patients under guardianship, trusteeship, or deprived of liberty

          -  Patients participating in another clinical research protocol involving a drug or
             medical device

          -  Patients unable to follow the protocol, according to the judgment of the investigator
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 40 Years old.


Eligibility (NLI label): Contradiction