Patient case (clinical description): A 40-year-old woman comes to the clinic complaining of gritty sensation in her eyes. She also has difficulty swallowing dry foods with no pain or heartburn.  The patient is a schoolteacher and must drink water frequently during lectures due to her mouth dryness.  She also reports occasional joint pain.  Medical history is not significant other than the confirmed Sjogren disease with no other rheumatologic disease.  She is sexually active with her husband and has 2 children both delivered by natural vaginal delivery. She has no history of any kind of surgery. Physical examination shows conjunctival erythema and cracking of the lips. The remainder of the examination and history is normal. Her lab result shows elevated ESR (50 mm/h)

Patient's own account: I went to the clinic because I had a terrible gritty sensation in my eyes. It was also hard to swallow dry food, but it didn't burn, and there was no pain. I'm a 40-year-old female school teacher and I should drink water for the lectures because otherwise, my mouth gets really dry. I also have joint pain from time to time. I have been diagnosed with Sjogren disease but no other rheumatologic disease. I have a husband, we're sexually active, and I also have two lovely children that I delivered both naturally. I never undergone any surgery. Physical examination when I came to the clinic, and it showed cracking on my lips and a pink eye. The rest was fine. I also did some lab tests, and they came back with high ESR.

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): Contradiction