The optimal cut-off points for ultrasonography-detected synovial thickness and effusion indicative of knee osteoarthritis have been determined in a community-dwelling cohort of men (n = 152) and women (n = 147) from the UK. ‘Normal’ effusion ranges were similar for men and women, but men had a wider ‘normal’ range for synovial hypertrophy than women. Optimal cut-off points for effusion were 7.4 mm and 5.3 mm for men and women, respectively, and 3.7 mm and 1.6 mm for synovial hypertrophy. A power Doppler signal was uncommon in healthy individuals in this cohort.