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: Proximal and Distal Therapeutic Approach in Pain and Lower Limb Kinematic in People With Patellofemoral Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

          -  Present anterior or retro patellar pain aggravated by two or more activities that
             overload the patellofemoral joint, such as going up and down stairs, squatting,
             remaining in the sitting position for long periods, getting up from the sitting
             position, kneeling or during physical exercise;

          -  Reporting pain of at least 3 on an 11-point scale (0 for no pain and 10 for the worst
             possible pain) during the activities described above and on most days during the last
             month;

          -  Have evidence of osteophyte formation in the patellofemoral joint on radiographs in
             the profile and axial skyline views through the Kellgren-Lawrence (K-L) grade ≥ 2,
             with minimal impairment in the tibiofemoral joint (KL <2);

          -  Body mass index (BMI) <35 Kg / m². Participants with unilateral or bilateral symptoms
             will be included in the study.

        Exclusion Criteria:

          -  Current use or in the last 12 months of foot orthoses;

          -  Previous history of fracture or recurrent subluxation of the patella;

          -  Arthroscopic surgery or knee infiltrations in the last 3 months;

          -  Osteoarthritis known in other weight-bearing joints, including the spine;

          -  History of surgery on the hip, knee, ankle and foot joints;

          -  History of ankle sprain in the last 12 months;

          -  Osteotomy in the lower limbs;

          -  Current physical therapy in the lower limbs or in the last 6 weeks;

          -  Use of a cane or other walking aid;

          -  Any physical disability that is a contraindication for carrying out the evaluations
             and;

          -  Punctuation that suggests dementia according to the Mini-Mental State Examination,
             taking into account the education of the participants.
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.
Subject must be at most 65 Years

Eligibility (NLI label): Entailment