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: Effectiveness of an Exercise Program and Education Through a Mobile Application for the Management of Patients With Hand Osteoarthritis and Rheumatoid Arthritis

Eligibility criteria:
Inclusion Criteria:

          1. Hand Osteoarthritis (OA) patients:

               -  Subjects with hand osteoarthritis according to the American College of
                  Rheumatology (ACR) classification criteria for clinical OA; hand pain, aching or
                  stiffness and 3 of the following points;

                    1. Hard tissue enlargement of 2 or more of 10 hand joints.

                    2. Hard tissue enlargement of 2 or more interphalangeal joints.

                    3. Fewer than 3 swollen Metacarpal joints.

                    4. Deformity of 1 or more of 10 hand joints.

               -  Pain and dysfunction in the joints of the hands and/or wrists

               -  Possession of a smartphone with internet.

          2. Rheumatoid Arthritis (RA) Hand patients:

               -  Subjects with hand arthritis according to the American College of Rheumatology
                  (ACR) clinical and immunological criteria for clinical RA. Patients must meet 4
                  of the following seven criteria:

                    1. Morning stiffness in and around joints lasting at least 1 hour.

                    2. Swelling in three or more joints.

                    3. Swelling in hand or wrist joints,

                    4. Symmetrical joint swelling.

                    5. erosions or decalcification on radiographs of hand and/or wrist.

                    6. Rheumatoid nodules.

                    7. Abnormal serum rheumatoid factor.

               -  Pain and dysfunction in the joints of the hands and/or wrists.

               -  Possession of a smartphone with internet

        Exclusion Criteria:

          1. Hand Osteoarthritis Patients:

               -  Age under 18 years

               -  People with cognitive impairment

               -  Surgery on any upper limb joint or fracture in the upper limb within the previous
                  6 months

               -  People on the waiting list for upper limb surgery.

               -  Persons who have received steroid injections into the joints of their hands in
                  the two months prior to recruitment.

               -  People with inflammatory rheumatic disease (arthritis, spondylitis or cancer)

          2. Rheumatoid Arthritis Hand Patients

               -  Age under 18 years

               -  People with cognitive impairment

               -  Surgery on any upper limb joint or fracture in the upper limb within the previous
                  6 months

               -  People on the waiting list for upper limb surgery.

               -  Pregnancy.
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