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Participants were characterized as having consistent frequent knee pain, radiographic OA (Kellgren\/Lawrence scale grade \u22652), symptomatic OA, and knee pain severity at the 60\u2010month visit (baseline). Widespread pain was categorized as pain above and below the waist, on both sides of the body and axially, using a standard homunculus, excluding knee pain. Incident widespread pain was defined as the presence of widespread pain at 84 months in those who were free of widespread pain at baseline. We assessed the relationship of baseline radiographic OA, symptomatic OA, consistent frequent knee pain, and knee pain severity, respectively, with incident widespread pain using logistic regression, adjusting for potential confounders, including models with and without pain severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, 1,129 subjects were eligible for analysis (mean\u2009\u00b1\u2009SD age 66.7\u2009\u00b1\u20097.8 years; mean\u2009\u00b1\u2009SD body mass index 30.1\u2009\u00b1\u20095.8 kg\/m<jats:sup>2<\/jats:sup>; 52% women). Radiographic OA in either knee (adjusted odds ratio [OR<jats:sub>adj<\/jats:sub>] 0.90 [95% confidence interval (95% CI) 0.63\u20131.30]; <jats:italic>P<\/jats:italic>\u2009=\u20090.587) was not associated with incident widespread pain. Baseline bilateral consistent frequent knee pain (OR<jats:sub>adj<\/jats:sub> 2.35 [95% CI 1.37\u20134.03]), bilateral symptomatic OA (OR<jats:sub>adj<\/jats:sub> 2.11 [95% CI 1.04\u20134.24]), and knee pain severity (worst knee) (OR<jats:sub>adj<\/jats:sub> 1.11 [95% CI 1.05\u20131.17]; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) were significantly associated with incident widespread pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Consistent frequent knee pain, symptomatic OA, and knee pain severity increased the risk of developing widespread pain, independently of structural pathology. These results suggest that knee pain, and not structural pathology, contributes to the onset of widespread pain.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23086","type":"journal-article","created":{"date-parts":[[2016,9,16]],"date-time":"2016-09-16T17:42:51Z","timestamp":1474047771000},"page":"826-832","source":"Crossref","is-referenced-by-count":24,"title":["Knee Pain and Structural Damage as Risk Factors for Incident Widespread Pain: Data From the Multicenter Osteoarthritis Study"],"prefix":"10.1002","volume":"69","author":[{"given":"Lisa C.","family":"Carlesso","sequence":"first","affiliation":[{"name":"University of Montreal Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil A.","family":"Segal","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Curtis","sequence":"additional","affiliation":[{"name":"University of Alabama Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barton L.","family":"Wise","sequence":"additional","affiliation":[{"name":"University of California Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Frey Law","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Nevitt","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuhina","family":"Neogi","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61729-2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059858"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu240"},{"key":"e_1_2_6_5_1","first-page":"1341","article-title":"Is chronic widespread pain a predictor of all\u2010cause morbidity? 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