['To examine the longitudinal relation of knee pain, radiographic osteoarthritis (ROA), symptomatic knee OA (SxOA) and knee pain severity to incident widespread pain (WSP).', 'The Multicenter Osteoarthritis Study is a longitudinal cohort of persons with or at risk of knee OA. Participants were characterized with regards to consistent frequent knee pain (CFKP), ROA (Kellgren & Lawrence grade ≥2), SxOA, and knee pain severity at the 60-month visit (baseline). WSP was defined as pain above and below the waist, on both sides of the body and axially, using a standard homunculus, excluding knee pain. Incident WSP was defined as presence of WSP at 84 months among those who were free of WSP at baseline. We assessed the relation of baseline ROA, SxOA, CFKP and knee pain severity, respectively, to incident WSP using logistic regression, adjusting for potential confounders including models with and without pain severity.', 'At baseline 1129 subjects were eligible for analysis (age mean, SD 66.7, 7.8; BMI 30.1, 5.8 kg/m'] Is knee Pain Severity Rather Than Structural Damage a Risk Factor for Incident Widespread Pain : The Multicenter Osteoarthritis ( MOST ) Study?