Patient case (clinical description): A 19-year-old girl comes to the clinic due to a left wrist mass.  She noticed swelling on the top of her wrist about 4 months ago and came to the clinic due to cosmetic concerns.  Examination shows a nontender, rounded mass on the dorsal wrist that transilluminates with a penlight. Vital signs are normal. The patient needs to type on her computer almost all day. She is left-handed. She does not smoke or use illicit drugs. She is in sexual relationship with two male partners and uses condoms.

Patient's own account: I'm a 19-year-old girl and I went to see my doctor because of a mass on my left wrist. I noticed a swelling on top of my wrist, like 4 months ago, and I went the first time to the doctor because it was pretty ugly! My wrist was not tender, and the mass was round and let the light go through when the doctor used a penlight. My blood pressure, breathing and temperature were normal. I'm left-handed and I need to be on my PC all day. I don't smoke or do drugs. I'm sexually active and I have 2 male partners but they all use condoms.

Clinical trial: The Nor-Hand Study

Eligibility criteria:
Inclusion Criteria:

          -  Age between 40-70 years at screening

          -  Proven hand OA by clinical examination and/or ultrasound

               1. Clinical examination criteria: Heberden/Bouchards nodes and/or bony enlargement,
                  squaring and/or deformity of the thumb base and no clinical signs of inflammatory
                  arthritis (e.g. soft tissue swelling of two or less metacarpophalangeal (MCP)
                  joints, and no soft tissue swelling of the wrist).

               2. Ultrasound criteria: Osteophytes in the interphalangeal joints and/or the thumb
                  base, and no signs of inflammatory arthritis (e.g. synovitis with power Doppler
                  activity in two or less MCP joints and no synovitis with power Doppler activity
                  in the wrist).

          -  Capable of understanding and signing an informed consent form

          -  Provided a written informed consent to participate in the study

        Exclusion Criteria:

          -  Diagnosis of inflammatory arthritic disease, e.g. seropositive or seronegative
             rheumatoid arthritis, psoriatic arthritis, reactive arthritis, spondyloarthritis or
             arthritis related to connective tissue disorders

          -  Diagnosis of psoriasis

          -  Erythrocyte sedimentation rate (ESR) > 40 mm/hour and/or C-reactive protein (CRP) >20
             mg/L, without a known ongoing infection

          -  Anti Cyclic Citrullinated Protein (anti-CCP) and/or rheumatoid factor positivity

          -  Ferritin >200 microgram/L for women and >300 microgram/L for men and s-iron/s-total
             iron binding capacity (TIBC) above 50%

          -  Major co-morbidities (e.g. severe malignancies, severe diabetes mellitus, severe
             infections, uncontrollable hypertension, severe cardiovascular disease or severe
             respiratory disease)

          -  Mental or psychiatric disorders, alcohol or drug abuse, language difficulties or other
             factors that make compliance to the study protocol difficult.
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