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: Acupuncture Treatment for Knee Osteoarthritis With Sensitive Acupoints and Tender Points

Eligibility criteria:
Inclusion Criteria:

          -  Participants aged 40 years or older and diagnosed with mild or moderate knee
             osteoarthritis(KOA) are eligible to participate in the study

          -  The following criteria are used for diagnosis of KOA:

               -  refractory knee pain for most days in the last month;

               -  joint space narrowing, sclerosis or cystic change in subchondral bone (as
                  demonstrated in X-ray);

               -  laboratory examinations of arthritis: clear and viscous synovial fluid (≥2 times)
                  and white blood cell count < 2000/mm3;

               -  morning stiffness continues less than 30 minutes;

               -  bone sound exists when joints was taking flexion and/or extension. If a patient
                  meets criteria 1 and 2, or criteria 1, 3, 4, and 5, a diagnosis of KOA is
                  confirmed.

        Exclusion Criteria:

        Patients will be excluded if they meet any of the following:

          -  diagnosed with conditions leading to skeletal disorders, such as tuberculosis, tumors
             or rheumatism of the knee joint and rheumatoid arthritis;

          -  present sprain or trauma in the lower limb;

          -  unable to walk properly due to foot deformity or pain;

          -  present with mental disorders;

          -  present with comorbidities including severe cardiovascular disease, liver or kidney
             impairment, immunodeficiency, diabetes mellitus, blood disorder or skin disease;

          -  females who are pregnant or lactating;

          -  using physiotherapy treatments for osteoarthritis knee pain;

          -  have used intra-articular injection of glucocorticoid or viscosupplementation in the
             past six months;

          -  received knee-replacement surgery;

          -  diagnosed with severe (stage 4, according to Kellgren and Lawrence radiographic
             classification) or late clinical stage of KOA;

          -  have a swollen knee or positive result of floating patella test; or'

          -  are participating or have participated in the other clinical trials.
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): Entailment