Knee Effusion-Synovitis Is Not Associated With Self-Reported Knee Pain in Division I Female Athletes

Background: Recent research indicates a potential link between effusion-synovitis and knee pain in athletes. This study investigates the association of knee effusion-synovitis with self-reported knee pain in elite female athletes, leveraging ultrasound imaging for effusion-synovitis assessment.Hypothesis: Presence of knee effusion-synovitis is associated with increased self-reported knee pain in Division I female athletes.Study Design: Cross-sectional study.Level of Evidence: Level 3.Methods: A total of 53 NCAA Division I female athletes underwent bilateral knee ultrasound to identify effusion-synovitis. The Knee Injury and Osteoarthritis Outcome Survey (KOOS) Pain subscale assessed knee pain. A 1-way analysis of variance compared KOOS pain, symptoms, activities during daily living (ADL), and quality of life (QoL) scores across groups with no, unilateral, and bilateral effusion-synovitis.Results: Among the athletes, 49.1% showed no effusion-synovitis, 26.4% had unilateral, and 24.5% had bilateral effusion-synovitis. There were no differences in self-reported pain scores (F = 0.027; P = 0.97), ADL (F = 0.256; P = 0.78), or QoL (F = 0.120; P = 0.88) between any groups. In addition, the frequency of effusion-synovitis was as follows: for the right limb, Grade 0 = 35 (66%), Grade 1 = 15 (28%), Grade 2 = 1 (2%), and Grade 3 = 2 (4%); for the left limb, Grade 0 = 31 (58%), Grade 1 = 19 (36%), Grade 2 = 3 (6%), and Grade 3 = 0 (0%).Conclusion: The presence of effusion-synovitis, irrespective of being unilateral or bilateral, was not associated with self-reported knee pain in elite female athletes. This suggests that lower grades of effusion-synovitis may not significantly impact knee pain.Clinical Relevance: The findings of this study challenge existing assumptions about the impact of effusion-synovitis on knee pain in athletes, contributing to the nuanced understanding of knee joint health in sports medicine.