Is There a Role for MRI to Establish Treatment Indications and Effectively Monitor Response in Patients with Axial Spondyloarthritis?

MRI has an important role in the assessment of axial spondyloarthritis (axSpA), particularly early in the disease course, before radiographic damage is apparent. For this reason, MRI was incorporated into the 2009 ASAS/OMERACT classification criteria for spondyloarthritis. However, there are current controversies regarding its use. Important questions include whether the spine should be used in the routine diagnosis and classification of axSpA, whether MRI should replace radiographs as the imaging modality of choice in axSpA, and whether MRI findings in axSpA have prognostic significance.