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: Aerobic Exercise Intervention for Knee Osteoarthritis

Eligibility criteria:
Inclusion Criteria

          -  Current symptoms of chronic (6 months), stable pain and/or stiffness in one or both
             knees during weight-bearing activities

          -  Involved joint is primary factor limiting physical or functional activity

          -  Radiographic signs of mild or moderate arthritis

          -  Mild joint space narrowing (at least 2mm remaining)

        Exclusion Criteria

          -  Current participation in a regular exercise program

          -  Existing medical condition that would preclude increased physical activity

          -  Subjective complaint of instability (giving way)

          -  Ligamentous instability greater than Grade I

          -  Knee flexion contracture greater than 15 degrees

          -  Asymptomatic osteoarthritis of both knees, incapacitating arthritis, or inflammatory
             arthritis

          -  Major reconstructive surgery on a lower extremity joint

          -  Multiple major joint involvement

          -  Any condition which severely limits local ambulation, such as amputation or stroke

          -  Gait aids used majority of time for ambulation

          -  Cannot use step-over-step techniques in either ascending or descending stair
             conditions

          -  Not able to undergo MRI scan (e.g., cardiac pacemaker)

          -  Dementia or inability to give informed consent as determined by a Folstein Mini Mental
             score greater than 24
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 30 Years old.


Eligibility (NLI label): Entailment