Automatic Knee Osteoarthritis Diagnosis from Plain Radiographs: A Deep Learning-Based Approach
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Abstract (arXiv)
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 Initiative dataset. Our method yielded a quadratic Kappa coefficient of 0.83 and average multiclass accuracy of 66.71% compared to the annotations given by a committee of clinical experts. Here, we also report a radiological OA diagnosis area under the ROC curve of 0.93. We also present attention maps -- given as a class probability distribution -- highlighting the radiological features affecting the network decision. This information makes the decision process transparent for the practitioner, which builds better trust toward automatic methods. We believe that our model is useful for clinical decision making and for OA research; therefore, we openly release our training codes and the data set created in this study.
Key facts. Cited by 42 papers in the map (data through 14 Oct 2026). First posted on arXiv 29 Oct 2017.
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Citing papers per year: 2021: 6; 2022: 7; 2023: 10; 2024: 10; 2025: 3; 2026: 6.
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- 2024Fr'echet Radiomic Distance (FRD): A Versatile Metric for Comparing Medical Imaging Datasetscited by 19
- 2024The Effect of Intrinsic Dataset Properties on Generalization: Unraveling Learning Differences Between Natural and Medical Imagescited by 13
- 2022Improving the repeatability of deep learning models with Monte Carlo dropoutcited by 11
- 2022The Intrinsic Manifolds of Radiological Images and their Role in Deep Learningcited by 10
- 2022Temporal Context Matters: Enhancing Single Image Prediction with Disease Progression Representationscited by 8
- 2021Knee Osteoarthritis Severity Prediction using an Attentive Multi-Scale Deep Convolutional Neural Networkcited by 6
- 2022Deep learning-based algorithm for assessment of knee osteoarthritis severity in radiographs matches performance of radiologistscited by 6
- 2022Knee Cartilage Defect Assessment by Graph Representation and Surface Convolutioncited by 3
- 2023Transformer with Selective Shuffled Position Embedding and Key-Patch Exchange Strategy for Early Detection of Knee Osteoarthritiscited by 3
- 2023Exploring the Efficacy of Base Data Augmentation Methods in Deep Learning-Based Radiograph Classification of Knee Joint Osteoarthritiscited by 3
- 2022Give me a knee radiograph, I will tell you where the knee joint area is: a deep convolutional neural network adventurecited by 2
- 2023Confidence-Driven Deep Learning Framework for Early Detection of Knee Osteoarthritiscited by 2
30 more
- 2023Automatic diagnosis of knee osteoarthritis severity using Swin transformercited by 2
- 2021DeepRA: Predicting Joint Damage From Radiographs Using CNN with Attentioncited by 1
- 2023A generalized framework to predict continuous scores from medical ordinal labelscited by 1
- 2023Synthesizing Bidirectional Temporal States of Knee Osteoarthritis Radiographs with Cycle-Consistent Generative Adversarial Neural Networkscited by 1
- 2023Adaptive Variance Thresholding: A Novel Approach to Improve Existing Deep Transfer Vision Models and Advance Automatic Knee-Joint Osteoarthritis Classificationcited by 1
- 2024Shifting Focus: From Global Semantics to Local Prominent Features in Swin-Transformer for Knee Osteoarthritis Severity Assessmentcited by 1
- 2024A Progressive Risk Formulation for Enhanced Deep Learning based Total Knee Replacement Prediction in Knee Osteoarthritiscited by 1
- 2024Temporal Evolution of Knee Osteoarthritis: A Diffusion-based Morphing Model for X-ray Medical Image Synthesiscited by 1
- 2024Pre-processing and Compression: Understanding Hidden Representation Refinement Across Imaging Domains via Intrinsic Dimensioncited by 1
- 2025VL-OrdinalFormer: Vision Language Guided Ordinal Transformers for Interpretable Knee Osteoarthritis Gradingcited by 1
- 2026Self-Supervised Learning for Knee Osteoarthritis: Diagnostic Limitations and Prognostic Value of Hospital Datacited by 1
- 2021A Practical Framework for ROI Detection in Medical Images -- a case study for hip detection in anteroposterior pelvic radiographscited by 0
- 2021Training Sparse Neural Network by Constraining Synaptic Weight on Unit Lp Spherecited by 0
- 2021Multipath CNN with alpha matte inference for knee tissue segmentation from MRIcited by 0
- 2021Coherence Learning using Keypoint-based Pooling Network for Accurately Assessing Radiographic Knee Osteoarthritiscited by 0
- 2022Knee arthritis severity measurement using deep learning: a publicly available algorithm with a multi-institutional validation showing radiologist-level performancecited by 0
- 2023Key-Exchange Convolutional Auto-Encoder for Data Augmentation in Early Knee Osteoarthritis Detectioncited by 0
- 2023Deciphering knee osteoarthritis diagnostic features with explainable artificial intelligence: A systematic reviewcited by 0
- 2023Improving Image Classification of Knee Radiographs: An Automated Image Labeling Approachcited by 0
- 2024An AI System for Continuous Knee Osteoarthritis Severity Grading Using Self-Supervised Anomaly Detection with Limited Datacited by 0
- 2024Identity-Consistent Diffusion Network for Grading Knee Osteoarthritis Progression in Radiographic Imagingcited by 0
- 2024Toward Cost-efficient Adaptive Clinical Trials in Knee Osteoarthritis with Reinforcement Learningcited by 0
- 2024Emory Knee Radiograph (MRKR) Datasetcited by 0
- 2025Diffusion-based Counterfactual Augmentation: Towards Robust and Interpretable Knee Osteoarthritis Gradingcited by 0
- 2025Stacked Ensemble of Fine-Tuned CNNs for Knee Osteoarthritis Severity Gradingcited by 0
- 2026PSSF: Early osteoarthritis detection using physical synthetic knee X-ray scans and AI radiomics modelscited by 0
- 2026ClinNet: Evidential Ordinal Regression with Bilateral Asymmetry and Prototype Memory for Knee Osteoarthritis Gradingcited by 0
- 2026AGE-Net: Spectral--Spatial Fusion and Anatomical Graph Reasoning with Evidential Ordinal Regression for Knee Osteoarthritis Gradingcited by 0
- 2026Opportunistic Bone-Loss Screening from Routine Knee Radiographs Using a Multi-Task Deep Learning Framework with Sensitivity-Constrained Threshold Optimizationcited by 0
- 2026Landmark-free Assessment of Lower-limb Alignment with Implicit Neural Shape Functions from Knee Radiographscited by 0
- 2026Landmark-free Assessment of Lower-limb Alignment with Implicit Neural Shape Functions from Knee Radiographs13 Jun 2026
- 2026Opportunistic Bone-Loss Screening from Routine Knee Radiographs Using a Multi-Task Deep Learning Framework with Sensitivity-Constrained Threshold Optimization22 Apr 2026
- 2026Self-Supervised Learning for Knee Osteoarthritis: Diagnostic Limitations and Prognostic Value of Hospital Data26 Mar 2026
- 2026AGE-Net: Spectral--Spatial Fusion and Anatomical Graph Reasoning with Evidential Ordinal Regression for Knee Osteoarthritis Grading24 Jan 2026
- 2026ClinNet: Evidential Ordinal Regression with Bilateral Asymmetry and Prototype Memory for Knee Osteoarthritis Grading24 Jan 2026
- 2026PSSF: Early osteoarthritis detection using physical synthetic knee X-ray scans and AI radiomics models14 Jan 2026
- 2025VL-OrdinalFormer: Vision Language Guided Ordinal Transformers for Interpretable Knee Osteoarthritis Grading31 Dec 2025
- 2025Stacked Ensemble of Fine-Tuned CNNs for Knee Osteoarthritis Severity Grading27 Nov 2025
- 2025Diffusion-based Counterfactual Augmentation: Towards Robust and Interpretable Knee Osteoarthritis Grading18 Jun 2025
- 2024Fr'echet Radiomic Distance (FRD): A Versatile Metric for Comparing Medical Imaging Datasets2 Dec 2024
- 2024Emory Knee Radiograph (MRKR) Dataset30 Oct 2024
- 2024Pre-processing and Compression: Understanding Hidden Representation Refinement Across Imaging Domains via Intrinsic Dimension15 Aug 2024
30 more
- 2024Toward Cost-efficient Adaptive Clinical Trials in Knee Osteoarthritis with Reinforcement Learning5 Aug 2024
- 2024Temporal Evolution of Knee Osteoarthritis: A Diffusion-based Morphing Model for X-ray Medical Image Synthesis1 Aug 2024
- 2024Identity-Consistent Diffusion Network for Grading Knee Osteoarthritis Progression in Radiographic Imaging31 Jul 2024
- 2024An AI System for Continuous Knee Osteoarthritis Severity Grading Using Self-Supervised Anomaly Detection with Limited Data16 Jul 2024
- 2024A Progressive Risk Formulation for Enhanced Deep Learning based Total Knee Replacement Prediction in Knee Osteoarthritis14 Jun 2024
- 2024Shifting Focus: From Global Semantics to Local Prominent Features in Swin-Transformer for Knee Osteoarthritis Severity Assessment15 Mar 2024
- 2024The Effect of Intrinsic Dataset Properties on Generalization: Unraveling Learning Differences Between Natural and Medical Images16 Jan 2024
- 2023Exploring the Efficacy of Base Data Augmentation Methods in Deep Learning-Based Radiograph Classification of Knee Joint Osteoarthritis10 Nov 2023
- 2023Adaptive Variance Thresholding: A Novel Approach to Improve Existing Deep Transfer Vision Models and Advance Automatic Knee-Joint Osteoarthritis Classification10 Nov 2023
- 2023Synthesizing Bidirectional Temporal States of Knee Osteoarthritis Radiographs with Cycle-Consistent Generative Adversarial Neural Networks10 Nov 2023
- 2023Improving Image Classification of Knee Radiographs: An Automated Image Labeling Approach6 Sep 2023
- 2023Deciphering knee osteoarthritis diagnostic features with explainable artificial intelligence: A systematic review18 Aug 2023
- 2023Automatic diagnosis of knee osteoarthritis severity using Swin transformer10 Jul 2023
- 2023A generalized framework to predict continuous scores from medical ordinal labels30 May 2023
- 2023Transformer with Selective Shuffled Position Embedding and Key-Patch Exchange Strategy for Early Detection of Knee Osteoarthritis17 Apr 2023
- 2023Confidence-Driven Deep Learning Framework for Early Detection of Knee Osteoarthritis23 Mar 2023
- 2023Key-Exchange Convolutional Auto-Encoder for Data Augmentation in Early Knee Osteoarthritis Detection26 Feb 2023
- 2022Deep learning-based algorithm for assessment of knee osteoarthritis severity in radiographs matches performance of radiologists25 Jul 2022
- 2022The Intrinsic Manifolds of Radiological Images and their Role in Deep Learning6 Jul 2022
- 2022Knee arthritis severity measurement using deep learning: a publicly available algorithm with a multi-institutional validation showing radiologist-level performance16 Mar 2022
- 2022Temporal Context Matters: Enhancing Single Image Prediction with Disease Progression Representations2 Mar 2022
- 2022Improving the repeatability of deep learning models with Monte Carlo dropout15 Feb 2022
- 2022Give me a knee radiograph, I will tell you where the knee joint area is: a deep convolutional neural network adventure11 Feb 2022
- 2022Knee Cartilage Defect Assessment by Graph Representation and Surface Convolution12 Jan 2022
- 2021Coherence Learning using Keypoint-based Pooling Network for Accurately Assessing Radiographic Knee Osteoarthritis16 Dec 2021
- 2021Multipath CNN with alpha matte inference for knee tissue segmentation from MRI29 Sep 2021
- 2021Knee Osteoarthritis Severity Prediction using an Attentive Multi-Scale Deep Convolutional Neural Network27 Jun 2021
- 2021Training Sparse Neural Network by Constraining Synaptic Weight on Unit Lp Sphere30 Mar 2021
- 2021A Practical Framework for ROI Detection in Medical Images -- a case study for hip detection in anteroposterior pelvic radiographs2 Mar 2021
- 2021DeepRA: Predicting Joint Damage From Radiographs Using CNN with Attention13 Feb 2021
- 2024Fr'echet Radiomic Distance (FRD): A Versatile Metric for Comparing Medical Imaging Datasetscited by 19
- 2024The Effect of Intrinsic Dataset Properties on Generalization: Unraveling Learning Differences Between Natural and Medical Imagescited by 13
- 2022Improving the repeatability of deep learning models with Monte Carlo dropoutcited by 11
- 2022The Intrinsic Manifolds of Radiological Images and their Role in Deep Learningcited by 10
- 2022Temporal Context Matters: Enhancing Single Image Prediction with Disease Progression Representationscited by 8
- 2021Knee Osteoarthritis Severity Prediction using an Attentive Multi-Scale Deep Convolutional Neural Networkcited by 6
- 2022Deep learning-based algorithm for assessment of knee osteoarthritis severity in radiographs matches performance of radiologistscited by 6
- 2022Knee Cartilage Defect Assessment by Graph Representation and Surface Convolutioncited by 3
- 2023Transformer with Selective Shuffled Position Embedding and Key-Patch Exchange Strategy for Early Detection of Knee Osteoarthritiscited by 3
- 2023Exploring the Efficacy of Base Data Augmentation Methods in Deep Learning-Based Radiograph Classification of Knee Joint Osteoarthritiscited by 3
- 2022Give me a knee radiograph, I will tell you where the knee joint area is: a deep convolutional neural network adventurecited by 2
- 2023Confidence-Driven Deep Learning Framework for Early Detection of Knee Osteoarthritiscited by 2
12 most cited of 41 All 41 (JSON)
- 2026Landmark-free Assessment of Lower-limb Alignment with Implicit Neural Shape Functions from Knee Radiographs13 Jun 2026
- 2026Opportunistic Bone-Loss Screening from Routine Knee Radiographs Using a Multi-Task Deep Learning Framework with Sensitivity-Constrained Threshold Optimization22 Apr 2026
- 2026Self-Supervised Learning for Knee Osteoarthritis: Diagnostic Limitations and Prognostic Value of Hospital Data26 Mar 2026
- 2026AGE-Net: Spectral--Spatial Fusion and Anatomical Graph Reasoning with Evidential Ordinal Regression for Knee Osteoarthritis Grading24 Jan 2026
- 2026ClinNet: Evidential Ordinal Regression with Bilateral Asymmetry and Prototype Memory for Knee Osteoarthritis Grading24 Jan 2026
- 2026PSSF: Early osteoarthritis detection using physical synthetic knee X-ray scans and AI radiomics models14 Jan 2026
- 2025VL-OrdinalFormer: Vision Language Guided Ordinal Transformers for Interpretable Knee Osteoarthritis Grading31 Dec 2025
- 2025Stacked Ensemble of Fine-Tuned CNNs for Knee Osteoarthritis Severity Grading27 Nov 2025
- 2025Diffusion-based Counterfactual Augmentation: Towards Robust and Interpretable Knee Osteoarthritis Grading18 Jun 2025
- 2024Fr'echet Radiomic Distance (FRD): A Versatile Metric for Comparing Medical Imaging Datasets2 Dec 2024
- 2024Emory Knee Radiograph (MRKR) Dataset30 Oct 2024
- 2024Pre-processing and Compression: Understanding Hidden Representation Refinement Across Imaging Domains via Intrinsic Dimension15 Aug 2024
12 newest of 41 All 41 (JSON)