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: Study of Effectiveness of Hand Exercises to Treat Symptoms of Hand Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

          -  Men and women

          -  Ages 50 years and older

          -  Reside within Tampa Bay Region, Florida

          -  Presence of symptomatic OA as determined by the AUSCAN Index. Specifically, a hand
             function score of > 225 mm for the AUSCAN VA-subscale

          -  Presence of radiographic hand OA, as defined by grades 2, or higher, per the Kellgren
             and Lawrence scale in one or more joints.

        Exclusion Criteria:

          -  Concomitant rheumatic disease (e.g., rheumatoid arthritis, gout, lupus, fibromyalgia)

          -  Current hand or wrist injury (e.g., carpal tunnel syndrome, palmer tenosynovitis,
             fracture, sprain)

          -  Use of an assistive device such as a cane or crutch

          -  Has hand surgery scheduled within the 48 weeks following the start of the study

          -  Prior hand surgery requiring joint replacement or other instrumentation in the hands

          -  Received any intra-articular injection (hyaluronic acid, corticosteroid, or joint
             lavage) during the 3 months preceding the study

          -  Currently participating in another conflicting research study

          -  Currently using a therapeutic hand cream or practicing a hand exercise routine

          -  Unwilling to sign an informed consent
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 50 Years old.


Eligibility (NLI label): Entailment