Osteoarthritis (OA) is one of the leading causes of labor loss in middle-aged and elderly patients, and is characterized by progressive loss of articular cartilage and the formation of bone fragments. To date, the pathogenesis of pain in osteoarthritis is unclear. Researchers at Boston University have used a case-control study to observe the relationship between pain and imaging manifestations in patients with osteoarthritis of the knee, providing a theoretical basis for the clinical prevention and treatment of osteoarthritis of the knee. The researchers screened participants from 2 large cohort studies of osteoarthritis, the Multicenter Osteoarthritis Study (MOST) and the Framingham Osteoarthritis Study, for inconsistent pain in the knee on 2 sides. The frequency and severity of knee pain on both sides were assessed using the Osteoarthritis Index (WOMAC), and the frequency and severity of knee pain on both sides were assessed by the Kellgren/Iawrence (K/L scale) (0-4) and osteophyte and joint cavity stenosis grading (0-3) of osteoarthritis imaging. The radiographic presentation of the knee joint. A total of 696 participants were enrolled in the MOST and 336 in the Framingham study. 418 (60%) of the participants in the MOST study were female, with a mean age of 62 years (standard deviation 8, 50-79) and a mean body mass index (BMI) of 31 (standard deviation 6, 18-56). In the Framingham study, 208 (62%) women, mean age 68 (standard deviation 10, 49-93), mean body mass index 29 (standard deviation 5, 17-58). Subjects’ K/L scores were strongly correlated with knee pain, with higher K/L scores having a higher chance of knee pain. In the MOST study and the Framingham 2 studies, the ORs for knee pain in subjects with a K/L score of 4 compared with those with a score of 0 were 151 (95% CI, 43 to 526) and 73 (16 to 331), respectively.