Methotrexate Treatment in Hand Osteoarthritis Refractory to Usual Treatments

Inclusion Criteria: \- Digital osteoarthritis (IPD and IPP) according to ACR criteria (with an X-ray of the hands taken less than 3 months ago, showing at least 3 joints with digital osteoarthritis KL\>=2) and symptomatic for more than three months Exclusion Criteria: * Having a bilirubin level \> 5 mg/dl (85.5 µmol/l) * Pregnant or breastfeeding women (a urine pregnancy test will be performed on women of childbearing age), * Injection of hyaluronic acid within the previous 6 months, * Injection of cortisone derivatives within the previous 3 months, * Presence of psoriasis, * Inflammatory rheumatism, * Microcrystalline arthropathy, * Joint prosthesis in one of the joints of the hand, * Planned placement of a joint prosthesis in the hand during the study period, * Major progressive disease (life-threatening cardiovascular disease, hematopoietic cancers including myeloma, cancers with risk of bone metastases), * Liver failure. * Severe renal failure (creatinine clearance less than 50 ml/min). * Positive hepatitis B serology. * Tuberculosis, hepatitis C, HIV positive, or other immunodeficiency syndromes. * Uncontrolled infections. * Use of corticosteroids. * Use of morphine derivatives, * Taking Bactrim, * Taking high doses of aspirin (greater than or equal to 500mg/day), * Contraindications to the use of methotrexate,