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<p>Knee Osteoarthritis is a progressive and chronic knee joint disease that shows symptoms of pain, stiffness, and swelling and is diagnosed by knee radiographs. These radiographs are evaluated by radiologists using Kellgren and Lawrence’s (KL) grading scheme. According to this scheme, the knee radiograph is graded from KL grade 0 (i.e., Normal) to KL grade 4 (i.e., Severe) to assess the KOA severity. For an automated system, the first step is to localize knee joints from knee radiographs and then classify them according to the KL grading system. In this work, we have proposed vision-based transformers to localize knee joints. We also proposed a single-stage model to localize the knee and classify KOA using a single model. We also explored and compared the performance of various transformers using a multiclass image classification strategy. Since KL grades maintain intrinsic ordinal information of KL grades, we employed an ordinal classification-based strategy to improve automated knee osteoarthritis classification performance. A total of 10 models are trained and validated on multiple datasets, and visualizations are generated for the best model for better comprehension. Our model obtained state-of-the-art results for knee detection and ordinal X-ray classification for KOA. Analysis of Variance (ANOVA) tests also indicate that the ordinal classification approach significantly improves the performance of models over traditional image classification approaches.</p>

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Ordinal classification for knee osteoarthritis x-rays using vision transformers

  • 期刊论文

  • 发表日期：

    2025年4月3日

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  • Tayyaba Tariq,
  • Zobia Suhail,
  • Zubair Nawaz

摘要

Knee Osteoarthritis is a progressive and chronic knee joint disease that shows symptoms of pain, stiffness, and swelling and is diagnosed by knee radiographs. These radiographs are evaluated by radiologists using Kellgren and Lawrence’s (KL) grading scheme. According to this scheme, the knee radiograph is graded from KL grade 0 (i.e., Normal) to KL grade 4 (i.e., Severe) to assess the KOA severity. For an automated system, the first step is to localize knee joints from knee radiographs and then classify them according to the KL grading system. In this work, we have proposed vision-based transformers to localize knee joints. We also proposed a single-stage model to localize the knee and classify KOA using a single model. We also explored and compared the performance of various transformers using a multiclass image classification strategy. Since KL grades maintain intrinsic ordinal information of KL grades, we employed an ordinal classification-based strategy to improve automated knee osteoarthritis classification performance. A total of 10 models are trained and validated on multiple datasets, and visualizations are generated for the best model for better comprehension. Our model obtained state-of-the-art results for knee detection and ordinal X-ray classification for KOA. Analysis of Variance (ANOVA) tests also indicate that the ordinal classification approach significantly improves the performance of models over traditional image classification approaches.