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: Measuring Gait And Self-Reported Pain In Patients With Osteoarthritis Of The Knee Using Placebo/Oxycodone/Celecoxib.

Eligibility criteria:
Inclusion Criteria:

          -  Subject has been taking an NSAID at least 15 of the past 30 days for index knee pain

          -  Grades 2 or 3 OA as defined by the Kellgren and Lawrence Grading System of the medial
             tibiofemoral joint (joint space narrowing in the medial compartment > lateral
             compartment as assessed by x-ray) using the Altman Atlas of OA7. This must be
             documented with a report from an x-ray of the study joint taken either at screening or
             within 1 year prior to screening

          -  Subject meets American College of Rheumatology (ACR) clinical classification criteria
             for osteoarthritis of the knee, defined by the following: Knee pain and at least 3 of
             the following: oAge >50 oMorning stiffness <30 minutes oCrepitus on active motion
             oBony tenderness oBony enlargement oNo palpable warmth of synovium.

        Exclusion Criteria:

          -  Subject has a documented history of an allergic reaction (hives, rash, etc.) or a
             clinically significant intolerance to celecoxib, sulfonamides, aspirin, or opioids
             including oxycodone

          -  Significant pain outside the index knee, including significant hip or back pain that
             can not be distinguished from OA pain or that interferes with ability to walk.
             (Patients with bilateral knee OA will be allowed into the study. The index knee should
             be defined as the more painful knee

          -  Predominantly patellofemoral knee osteoarthritis in the index knee as assessed by
             clinical examination

          -  Subject who are unable to discontinue all formulations of prior analgesics other than
             acetaminophen during the Washout Period of the study, or who are anticipated to be
             unable to discontinue rescue medication for 24 hours prior to the respective visits.
             (Low dose aspirin may be taken for cardiac prophylaxis

          -  Excessive signal knee joint laxity indicative of functional ligamentous deficiency
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 70 Years

Eligibility (NLI label): Contradiction