# A generalizable large-scale foundation model for musculoskeletal radiographs

arXiv: https://arxiv.org/abs/2602.03076 · HTML: https://mlsanity.com/paper/2602.03076/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- First posted on arXiv 3 Feb 2026.

## Abstract (arXiv)

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.