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: Splinting to Treat Hand Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

          -  Aged 18 - 90

          -  Definite diagnosis of IPJ osteoarthritis (American College of Rheumatology criteria
             for OA)

          -  A previous radiograph of the hands with changes consistent with OA

          -  Either, Intervention group: At least 2 'affected' IPJs (symptomatic (>2/10 average
             pain on 0-10 scale in past week) and radiological OA associated with 10 degrees of
             either radial or ulnar deviation of the joint evident clinically and on Xray)

          -  OR Control group: At least 1 'affected' IPJ (symptomatic (>2/10 average pain on 0-10
             scale in past week) and radiological OA associated with 10 degrees of either radial or
             ulnar deviation of the joint evident clinically and on X-ray)

          -  Stable oral therapy for month prior to study entry e.g. non steroidal
             anti-inflammatory drugs (NSAIDs)

          -  Capable of providing written informed consent

        Exclusion Criteria:

          -  Contraindication to splinting e.g. allergy to materials

          -  Planned surgery during study period

          -  Oral, intramuscular or intraarticular steroids within 3 months of study entry

          -  Intraarticular hyaluronans to any nominated IP joints within 6 months of study entry

          -  Not resident in UK

          -  Pregnancy

          -  Other inflammatory arthritis

          -  History of psoriasis

          -  Participation in other intervention trials

          -  Patients with any uncontrolled or severe medical problems which in the opinion of the
             investigator makes them unsuitable for study participation

          -  Unable to give informed written consent in English
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 90 Years

Eligibility (NLI label): Entailment