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Painful knee was assessed regarding having pain: ever, in the last year, in the last 6\u00a0months and in the last month. Using factor analysis, participants were graded using a knee pain score, with higher scores representing more symptomatology. Depressive symptoms were evaluated with the Beck Depressive Inventory (BDI), and radiographic knee OA was classified using the Kellgren Lawrence (KL) scale; those with KL \u2265 2 were considered as having radiographic OA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Knee pain was reported by 53.2% of those with radiographic KL \u2265 2 and by 33.2% of those with radiographic KL &lt; 2. The prevalence of depressive symptoms (BDI &gt; 14) was 19.9% among participants with radiographic KL \u2265 2 and 12.6% among those with radiographic KL &lt; 2 (<jats:italic>p<\/jats:italic> = 0.01). The association of knee pain with radiographic knee OA was higher in higher pain scores and in participants without depressive symptoms. Among participants with BDI \u2264 14 the likelihood ratio to identify patients with radiographic knee OA increased with increased pain scores: 1.02 for score 1; 2.19 for score 2 and 7.34 when participants responded positively to all pain questions (score 3). Among participants with depressive symptoms (BDI &gt; 14) likelihood ratios were 0.51, 1.92, 1.82, respectively. The results were similar for both genders.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Knee pain scores increased ability to identify participants with radiographic KL \u2265 2 in both sexes. However, the presence of depressive symptoms impairs the ability of knee pain complaints to identify patients with radiographic OA.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2474-14-214","type":"journal-article","created":{"date-parts":[[2013,7,22]],"date-time":"2013-07-22T10:14:02Z","timestamp":1374488042000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The effect of depressive symptoms on the association between radiographic osteoarthritis and knee pain: a cross-sectional study"],"prefix":"10.1186","volume":"14","author":[{"given":"Duarte","family":"Pereira","sequence":"first","affiliation":[]},{"given":"Milton","family":"Severo","sequence":"additional","affiliation":[]},{"given":"Henrique","family":"Barros","sequence":"additional","affiliation":[]},{"given":"Jaime","family":"Branco","sequence":"additional","affiliation":[]},{"given":"Rui A","family":"Santos","sequence":"additional","affiliation":[]},{"given":"Elisabete","family":"Ramos","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2013,7,22]]},"reference":[{"issue":"4","key":"1848_CR1","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1136\/ard.57.4.203","volume":"57","author":"E Odding","year":"1998","unstructured":"Odding E, Valkenburg HA, Algra D, Vandenouweland FA, Grobbee DE, Hofman A: Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam Study. 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