Measurement of Medial Elbow Joint Space using Landmark Detection

Ultrasound imaging of the medial elbow is crucial for the early identification of Ulnar Collateral Ligament (UCL) injuries. Specifically, measuring the elbow joint space in ultrasound images is used to assess the valgus instability of elbow. To automate this measurement, a precisely annotated dataset is necessary; however, no publicly available dataset has been proposed thus far. This study introduces a novel ultrasound medial elbow dataset for measuring joint space to diagnose Ulnar Collateral Ligament (UCL) injuries. The dataset comprises 4,201 medial elbow ultrasound images from 22 subjects, with landmark annotations on the humerus and ulna. The annotations are made precisely by the authors under the supervision of three orthopedic surgeons. We evaluated joint space measurement methods using our proposed dataset with several landmark detection approaches, including ViTPose, HRNet, PCT, YOLOv8, and U-Net. In addition, we propose using Shape Subspace (SS) for landmark refinement in heatmap-based landmark detection. The results show that the mean Euclidean distance error of joint space is 0.116 mm when using HRNet. Furthermore, the SS landmark refinement improves the mean absolute error of landmark positions by 0.010 mm with HRNet and by 0.103 mm with ViTPose on average. These highlight the potential for high-precision, real-time diagnosis of UCL injuries and associated risks, which could be leveraged in large-scale screening. Lastly, we demonstrate point-based segmentation of the humerus and ulna using the detected landmarks as input. The dataset will be made publicly available upon acceptance of this paper at: https://github.com/Akahori000/Ultrasound-Medial-Elbow-Dataset.