Identity-Consistent Diffusion Network for Grading Knee Osteoarthritis Progression in Radiographic Imaging

Wenhua Wu, Kun Hu, Wenxi Yue, Wei Li, Milena Simic +3 more
2/14/2026

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Abstract

Knee osteoarthritis (KOA), a common form of arthritis that causes physical disability, has become increasingly prevalent in society. Employing computer-aided techniques to automatically assess the severity and progression of KOA can greatly benefit KOA treatment and disease management. Particularly, the advancement of X-ray technology in KOA demonstrates its potential for this purpose. Yet, existing X-ray prognosis research generally yields a singular progression severity grade, overlooking the potential visual changes for understanding and explaining the progression outcome. Therefore, in this study, a novel generative model is proposed, namely Identity-Consistent Radiographic Diffusion Network (IC-RDN), for multifaceted KOA prognosis encompassing a predicted future knee X-ray scan conditioned on the baseline scan. Specifically, an identity prior module for the diffusion and a downstream generation-guided progression prediction module are introduced. Compared to conventional image-to-image generative models, identity priors regularize and guide the diffusion to focus more on the clinical nuances of the prognosis based on a contrastive learning strategy. The progression prediction module utilizes both forecasted and baseline knee scans, and a more comprehensive formulation of KOA severity progression grading is expected. Extensive experiments on a widely used public dataset, OAI, demonstrate the effectiveness of the proposed method.

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@article{wu2026identityconsistent,
  title  = {Identity-Consistent Diffusion Network for Grading Knee Osteoarthritis Progression in Radiographic Imaging},
  author = {Wenhua Wu and Kun Hu and Wenxi Yue and Wei Li and Milena Simic and ChangYang Li and Wei Xiang and Zhiyong Wang},
  year   = {2026},
  eprint = {2407.21381},
  archivePrefix = {arXiv},
  url    = {https://arxiv.org/abs/2407.21381},
  journal = {ECCV 2024 2024}
}

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