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: 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): Entailment