Novel imaging modalities in spondyloarthritis

Novel imaging techniques have emerged in the field of spondyloarthritis. This article will cover the role of, and the sensitivity and specificity of magnetic resonance imaging (MRI) and ultrasound in the diagnosis and monitoring of axial and peripheral SpA. It will discuss how the definition of a ‘positive MRI’ of the sacroiliac joints and spine is evolving. Differential diagnoses of inflammatory lesions of both the sacroiliac joints and the spine are addressed due to their importance in image interpretation. The article will also discuss the role of sonography in assessing peripheral entheses, joints, tendon sheaths, nails and soft tissues. The utility for clinical as well as an outcome measure will be discussed. We finally aim to give guidance on when and how to use these new modalities and on how to analyse and interpret the imaging findings in daily practice.