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Artificial Intelligence (AI) Can Diagnose Osteoporosis from Hip X-Rays

By MedImaging International staff writers
Posted on 26 May 2022

Image: An AI model can automatically diagnose osteoporosis from hip X-rays (Photo courtesy of Pexels)

People with osteoporosis, a skeletal disease that thins and weakens bones, are susceptible to fracture associated with bone fragility, resulting in poor quality of life and increased mortality. Early screening for osteoporosis with dual-energy X-ray absorptiometry (DXA) to assess bone mineral density is an important tool for timely treatment that can reduce the risk of fractures. However, the low availability of the scanners and the relatively high cost has limited its use for screening and post-treatment follow-up. In contrast, plain X-ray is widely available and is used frequently for various clinical indications in daily practice. Despite these attributes, it has been relatively underutilized in the management of osteoporosis because diagnosing osteoporosis using only X-rays is challenging even for an experienced radiologist. Now, a new method that combines imaging information with artificial intelligence (AI) can diagnose osteoporosis from hip X-rays and could help speed treatment to patients before fractures occur.

Researchers at Seoul National University Hospital (Seoul, Korea) have developed a model that can automatically diagnose osteoporosis from hip X-rays. The method combines radiomics, a series of image processing and analysis methods to obtain information from the image, with deep learning, an advanced type of AI. Deep learning can be trained to find patterns in images associated with disease.

The researchers developed the deep-radiomics model using almost 5,000 hip X-rays from 4,308 patients obtained over more than 10 years. They developed the models with a variety of deep, clinical and texture features and then tested them externally on 444 hip X-rays from another institution. The deep-radiomics model with deep, clinical, and texture features was able to diagnose osteoporosis on hip X-rays with superior diagnostic performance than the models using either texture or deep features alone, enabling opportunistic diagnosis of osteoporosis.

“For patients with hip pain, radiologists often evaluate only image findings that may cause pain, such as fractures, osteonecrosis and osteoarthritis,” said study author Hee-Dong Chae, M.D., from the Department of Radiology at Seoul National University Hospital. “Although X-ray images contain more information about the healthiness of the patient’s bones and muscles, this information is often overlooked or considered less important.”

“Our study shows that opportunistic detection of osteoporosis using these X-ray images is advantageous, and our model can serve as a triage tool recommending DXA in patients with highly suspected osteoporosis,” Dr. Chae added.

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71 (119.92454528809): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793085 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (36.001205444336): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (24.080276489258): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (42.915344238281): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793085 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (26.941299438477): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793085 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (30.994415283203): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 4569.0536499023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

105 (100.85105895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

106 (74.148178100586): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793085 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (49.114227294922): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793085 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

109 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

110 (45.061111450195): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793085 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (365.9725189209): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793085 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (567.91305541992): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (334.02442932129): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

115 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

116 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

117 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

118 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

119 (42.200088500977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

120 (237.94174194336): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 47571.182250977): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (272.98927307129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

123 (179.05235290527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

124 (!!!!! 1878.9768218994): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793085 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793085 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 881003.1414032): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (72.002410888672): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (43.153762817383): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (41.007995605469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (28.848648071289): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (28.848648071289): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (463.00888061523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (340.93856811523): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (272.03559875488): SELECT name FROM jos_deeppockets WHERE id=211

136 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=211

137 (419.13986206055): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (329.97131347656): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

140 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

141 (!!!!! 7254.8389434814): TRUNCATE TABLE jos_trademed_module

142 (77.009201049805): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793085 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (51.975250244141): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793085 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (740.05126953125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

147 (39.815902709961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

148 (!!!!! 1139.8792266846): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

150 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

151 (37.908554077148): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793085 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793085 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (35.04753112793): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

153 (26.941299438477): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

154 (30.040740966797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (697.85118103027): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

156 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793085 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793085 AND published='1' LIMIT 1

157 (35.04753112793): select jos_twitters.link from jos_twitters where cat=10

158 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

159 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

160 (29.802322387695): select jos_linkedin.link from jos_linkedin where cat=10

161 (223.15979003906): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1115.083694458): insert into jos_banners_delta values (14615,'2025-04-30 14:28:34','18.188.60.146','view'),(14202,'2025-04-30 14:28:34','18.188.60.146','view'),(14203,'2025-04-30 14:28:34','18.188.60.146','view')

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