Table 2.

Themes with additional illustrative quotes.

Theme	Illustrative Quotes
Insidious and Episodic Onset	“I think initially, ahm, a lot of it started in an insidious way in that, ah, oh, you go to bed and your leg would be tired or it would be sore and achey, and you wouldn't think too much of it …” - FG Canada, Toronto 2 “… it doesn't sort of suddenly come, you know, it's a gradual thing.” - FG UK 3 “… gradually more and more.” - FG Canada, Toronto 1 “It was like it would come on and then disappear, and come on again. I'd be in the shopping mall, I feel this, ah, just pain in my legs. And it continued like that.” - FG USA 3 “Intensity was not at much at first ….” - FG Canada, Toronto 1 “It started off just with a sort of little needle in my … and it got worse and worse for longer and longer and longer periods.” - FG Australia 3
Diverse Early Symptoms	“Mine started out when I was active, and that's when my knees would hurt, originally.” - FG Canada, Toronto 1 “Yeah, I don't think it even occurred to me that I had a problem, except [when] I did stairs.” - FG Canada, Vancouver 1 “… no pain, only stiffness.” - FG Australia 3 “you get crunching” - FG UK 3 “But, the one thing I can remember is the (unclear), used to be a clicking noise.” - FG Canada, Toronto 1 “… [challenges in] getting up from the floor (laughs).” - FG USA 2
Must Be Something Else	“I've always done a lot of walking, and I think ahm, also fallen on my knees a lot, so I think at first I just thought it was a bruise.” - FG Canada, Toronto 3 “maybe I hurt myself in the garden.” - FG Canada, Toronto 4 “Yeah all the concrete that's put down, and then the pressure on the knees because of that?” - FG UK 3 “I couldn't believe it was arthritis.” - FG Canada, Toronto 5
Adjustments	“I didn't give up walking, and I just stayed more or less on a more level [ground].” - FG Canada, Vancouver 1 “But it's just ahm, I guess just not being able to run. (Laughter) That gets your attention.” - FG USA 2 “Can't drive long distances.” - FG Australia 1