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: MRgFUS in the Treatment of Hand and Hip Osteoarthritic Pain

Eligibility criteria:
Inclusion Criteria:

          -  Male and female aged between 45 and 90 years

          -  Presence of activity-related joint pain

          -  Patients who have either no morning joint-related stiffness or morning stiffness that
             lasts no longer than 30 minutes

          -  Patients who have not responded to previous treatments,

          -  Patients with a baseline pain intensity of 4 to 8 on a 10-cm VAS

          -  Patients who are not candidates for immediate surgery

          -  Signed statement of informed consent (approved by Ethics Committee)

        Exclusion Criteria:

          -  Prior surgery or previous local treatment (infiltration, other) in the past 3 months

          -  Changes in medications used during the previous 2 months

          -  Intravenous drug use

          -  Corticosteroid use of more than 3 months within the preceding year

          -  Diagnosis of other rheumatologic disorders

          -  Trauma, fracture, or osteomyelitis of the investigated joints within the preceding
             year

          -  Any neurological disease or disorders potentially affecting pain perception

          -  Fibromyalgia

          -  Pregnancy

          -  Patients with large scar at skin or deeper soft tissue potentially included in the
             planned path of the ultrasound beam

          -  General contraindications to MRI and/or to anaesthesiological procedures planned for
             the patient

          -  Presence of internal hardware or devices potentially affecting MR thermometry
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 45 Years old.
Subject must be at most 90 Years

Eligibility (NLI label): Entailment