This is a translated write-up of a solution that finished 19th in the RSNA Knee Abnormality Detection competition on Kaggle. The original write-up is titled 19th Place Solution. The title points to ensemble distillation, MedSAM crops and LLM labeling as parts of the approach. The author also writes about competitions on the Telegram channel Pseudolabeling, where breakdowns and notes that do not fit into larger articles can be found.