Researchers reported that approximately 20% of people with axial spondyloarthritis (axSpA) included in a prospective cohort study had no lesions in the sacroiliac joints, only in the spine.[1] This finding suggests that MRI of the spine may improve disease management.[1] The study highlights the importance of advanced spine imaging in the diagnosis of axSpA.[1] MRI is recommended to be used with a device of at least 1.5 Tesla to detect inflammatory changes.[1][2] When examining the spine, sagittal sections 3–4 mm thick are used to capture affected areas such as pedicles, intervertebral joints or costotransverse joints.[1] In the case of unclear findings in the sacroiliac joints, an MRI of the spine is added, especially in the areas with the most pronounced pain.[2][3] The presence of bone edema in three or more vertebral corners is a characteristic finding.[6] MRI of the spine is not the first choice in diagnosis, but it increases the sensitivity by 16%.[2]