A generalizable large-scale foundation model for musculoskeletal radiographs
Seoul National University Hospital（首尔大学医院）；Seoul National University（首尔大学）；Seoul National University College of Medicine（首尔大学医学院）；Seoul National University Bundang Hospital（首尔大学盆唐医院）
Shinn Kim, Soobin Lee, Kyoungseob Shin, Han-Soo Kim, Yongsung Kim, Minsu Kim, Juhong Nam, Somang Ko, Daeheon Kwon, Wook Huh, Ilkyu Han, Sunghoon Kwon
Artificial intelligence (AI) has shown promise in detecting and characterizing musculoskeletal diseases from radiographs. However, most existing models remain task-specific, annotation-dependent, and limited in generalizability across diseases and anatomical regions. Although a generalizable foundation model trained on large-scale musculoskeletal radiographs is clinically needed, publicly available datasets remain limited in size and lack sufficient diversity to enable training across a wide range of musculoskeletal conditions and anatomical sites. Here, we present SKELEX, a large-scale foundation model for musculoskeletal radiographs, trained using self-supervised learning on 1.2 million diverse, condition-rich images. The model was evaluated on 12 downstream diagnostic tasks and generally outperformed baselines in fracture detection, osteoarthritis grading, and bone tumor classification. Furthermore, SKELEX demonstrated zero-shot abnormality localization, producing error maps that identified pathologic regions without task-specific training. Building on this capability, we developed an interpretable, region-guided model for predicting bone tumors, which maintained robust performance on independent external datasets and was deployed as a publicly accessible web application. Overall, SKELEX provides a scalable, label-efficient, and generalizable AI framework for musculoskeletal imaging, establishing a foundation for both clinical translation and data-efficient research in musculoskeletal radiology.
Virginia Polytechnic Institute and State University (Virginia Tech)（弗吉尼亚理工大学（Virginia Tech））；Department of Mechanical Engineering（机械工程系）；Autonomous Systems and Intelligent Machines (ASIM) Lab（自主系统与智能机器（ASIM）实验室）；Graduate Research Assistant（研究生研究助理）
This paper introduces MuRAD (Musculoskeletal Radiograph Abnormality Detection tool), a tool that can help radiologists automate the detection of abnormalities in musculoskeletal radiographs (bone X-rays). MuRAD utilizes a Convolutional Neural Network (CNN) that can accurately predict whether a bone X-ray is abnormal, and leverages Class Activation Map (CAM) to localize the abnormality in the image. MuRAD achieves an F1 score of 0.822 and a Cohen's kappa of 0.699, which is comparable to the performance of expert radiologists.
Google-MedGemma Based Abnormality Detection in Musculoskeletal radiographs
University of Texas at Arlington, Texas, United States（德克萨斯大学阿灵顿分校）；University of Engineering and Management, Kolkata, India（工程与管理大学）；Sardar Vallabhbhai National Institute of Technology, Surat, India（萨达尔·瓦拉布尔希国家理工学院）
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）
Osteoarthritis (OA) is a common musculoskeletal condition typically diagnosed from radiographic assessment after clinical examination. However, a visual evaluation made by a practitioner suffers from subjectivity and is highly dependent on the experience. Computer-aided diagnostics (CAD) could improve the objectivity of knee radiographic examination. The first essential step of knee OA CAD is to automatically localize the joint area. However, according to the literature this task itself remains challenging. The aim of this study was to develop novel and computationally efficient method to tack…
University of Oulu（奥卢大学）；Tampere University of Technology（坦佩雷理工大学）；Oulu University Hospital（奥卢大学医院）
Knee osteoarthritis (OA) is the most common musculoskeletal disorder. OA diagnosis is currently conducted by assessing symptoms and evaluating plain radiographs, but this process suffers from subjectivity. In this study, we present a new transparent computer-aided diagnosis method based on the Deep Siamese Convolutional Neural Network to automatically score knee OA severity according to the Kellgren-Lawrence grading scale. We trained our method using the data solely from the Multicenter Osteoarthritis Study and validated it on randomly selected 3,000 subjects (5,960 knees) from Osteoarthritis …
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；Erasmus MC, University Medical Center Rotterdam（伊拉斯谟医学中心，鹿特丹大学医学中心）；University Medical Center Rotterdam（鹿特丹大学医学中心）；Tampere University of Technology（坦佩雷理工大学）
Knee osteoarthritis (OA) is the most common musculoskeletal disease without a cure, and current treatment options are limited to symptomatic relief. Prediction of OA progression is a very challenging and timely issue, and it could, if resolved, accelerate the disease modifying drug development and ultimately help to prevent millions of total joint replacement surgeries performed annually. Here, we present a multi-modal machine learning-based OA progression prediction model that utilizes raw radiographic data, clinical examination results and previous medical history of the patient. We validate…
A multimodal vision foundation model for generalizable knee pathology
Beihang University（北京航空航天大学）；Peking University Third Hospital（北京大学第三医院）；Institute of Sports Medicine of Peking University（北京大学运动医学研究所）；Ministry of Education（教育部）
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；Medical Research Center, University of Oulu and Oulu University Hospital（奥卢大学与奥卢大学医院医学研究中心）
Knee osteoarthritis (OA) is very common progressive and degenerative musculoskeletal disease worldwide creates a heavy burden on patients with reduced quality of life and also on society due to financial impact. Therefore, any attempt to reduce the burden of the disease could help both patients and society. In this study, we propose a fully automated novel method, based on combination of joint shape and convolutional neural network (CNN) based bone texture features, to distinguish between the knee radiographs with and without radiographic osteoarthritis. Moreover, we report the first attempt a…
University of Wisconsin（威斯康星大学）；Henry Ford Health（亨利福特医疗集团）
Purpose: To answer the long-standing question of whether a model trained from a single clinical site can be generalized to external sites. Materials and Methods: 17,537 chest x-ray radiographs (CXRs) from 3,264 COVID-19-positive patients and 4,802 COVID-19-negative patients were collected from a single site for AI model development. The generalizability of the trained model was retrospectively evaluated using four different real-world clinical datasets with a total of 26,633 CXRs from 15,097 patients (3,277 COVID-19-positive patients). The area under the receiver operating characteristic curve…
Mayo Clinic（梅奥诊所）；Case Western Reserve University（凯斯西储大学）；University of Southern Maine（南缅因大学）；Dubyak Center for Digital Science and Innovation, University of Southern Maine（南缅因大学Dubyak数字科学与创新中心）；Department of Artificial Intelligence and Informatics, Mayo Clinic（梅奥诊所人工智能与信息学系）；Department of Health Sciences Research, Mayo Clinic（梅奥诊所健康科学研究系）；Department of Computer and Data Sciences, Case Western Reserve University（凯斯西储大学计算机与数据科学系）；Department of Orthopedics, Mayo Clinic（梅奥诊所骨科系）；Department of Computer Science, University of Southern Maine（南缅因大学计算机科学系）
Knee pain is undoubtedly the most common musculoskeletal symptom that impairs quality of life, confines mobility and functionality across all ages. Knee pain is clinically evaluated by routine radiographs, where the widespread adoption of radiographic images and their availability at low cost, make them the principle component in the assessment of knee pain and knee pathologies, such as arthritis, trauma, and sport injuries. However, interpretation of the knee radiographs is still highly subjective, and overlapping structures within the radiographs and the large volume of images needing to be …
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）
Knee osteoarthritis (OA) is the most common musculoskeletal disease in the world. In primary healthcare, knee OA is diagnosed using clinical examination and radiographic assessment. Osteoarthritis Research Society International (OARSI) atlas of OA radiographic features allows to perform independent assessment of knee osteophytes, joint space narrowing and other knee features. This provides a fine-grained OA severity assessment of the knee, compared to the gold standard and most commonly used Kellgren-Lawrence (KL) composite score. However, both OARSI and KL grading systems suffer from moderate…
University of Oulu（奥卢大学）；Oulu University Hospital（奥卢大学医院）；KU Leuven（鲁汶大学）；Ailean Technologies Oy
Knee osteoarthritis (OA) is one of the highest disability factors in the world. This musculoskeletal disorder is assessed from clinical symptoms, and typically confirmed via radiographic assessment. This visual assessment done by a radiologist requires experience, and suffers from moderate to high inter-observer variability. The recent literature has shown that deep learning methods can reliably perform the OA severity assessment according to the gold standard Kellgren-Lawrence (KL) grading system. However, these methods require large amounts of labeled data, which are costly to obtain. In thi…
Feasibility Study of a Diffusion-Based Model for Cross-Modal Generation of Knee MRI from X-ray: Integrating Radiographic Feature Information
Massachusetts General Hospital（麻省总医院）；Harvard Medical School（哈佛医学院）；University Sorbonne Paris Nord（巴黎北大索邦大学）；German Cancer Research Center（德国癌症研究中心）；Jiangsu Institute of Hematology（江苏血液学研究所）；The First Affiliated Hospital of Soochow University（苏州大学附属第一医院）；Henan University of Chinese Medicine（河南中医药大学）；Athinoula A. Martinos Centre for Biomedical Imaging（阿西努拉·A.马蒂诺斯生物医学成像中心）；IDP Institute（IDP研究所）；University of Orleans（奥尔良大学）
Digitization techniques for biomedical images yield different visual patterns in radiological exams. These differences may hamper the use of data-driven approaches for inference over these images, such as Deep Neural Networks. Another noticeable difficulty in this field is the lack of labeled data, even though in many cases there is an abundance of unlabeled data available. Therefore an important step in improving the generalization capabilities of these methods is to perform Unsupervised and Semi-Supervised Domain Adaptation between different datasets of biomedical images. In order to tackle …
OrthoDiffusion: A Generalizable Multi-Task Diffusion Foundation Model for Musculoskeletal MRI Interpretation
Center for Applied Statistics and School of Statistics（应用统计中心和统计学院）；Renmin University of China（中国人民大学）；Institute of Sports Medicine of Peking University（北京大学运动医学研究所）；Beijing Key Laboratory of Research and Translation for Drugs and Medical Devices in Precision Diagnosis and Treatment of Sports Injuries（北京体育损伤精准诊断与治疗药物与医疗设备研究翻译重点实验室）；State Key Laboratory of Virtual Reality Technology and Systems（虚拟现实技术与系统国家重点实验室）
IMT Atlantique（大西洋国立高等矿业电信学校）；LaTIM UMR 1101, Inserm（法国国家健康与医学研究院LaTIM UMR 1101实验室）；Centre Hospitalier Régional et Universitaire (CHRU) de Brest（布雷斯特大学区域中心医院）；Fondation ILDYS（ILDYS基金会）；Symbiosis Center for Medical Image Analysis, Symbiosis International University（共生国际大学共生医学图像分析中心）
Clinical diagnosis of the pediatric musculoskeletal system relies on the analysis of medical imaging examinations. In the medical image processing pipeline, semantic segmentation using deep learning algorithms enables an automatic generation of patient-specific three-dimensional anatomical models which are crucial for morphological evaluation. However, the scarcity of pediatric imaging resources may result in reduced accuracy and generalization performance of individual deep segmentation models. In this study, we propose to design a novel multi-task, multi-domain learning framework in which a …
Detecting anomalies in musculoskeletal radiographs is of paramount importance for large-scale screening in the radiology workflow. Supervised deep networks take for granted a large number of annotations by radiologists, which is often prohibitively very time-consuming to acquire. Moreover, supervised systems are tailored to closed set scenarios, e.g., trained models suffer from overfitting to previously seen rare anomalies at training. Instead, our approach's rationale is to use task agnostic pretext tasks to leverage unlabeled data based on a cross-sample similarity measure. Besides, we formu…
