[Correspondence] An imaging crisis in axial spondyloarthritis

We read with great interest the Viewpoint by Torsten Diekhoff and Denis Poddubnyy on the challenges of imaging in axial spondyloarthritis.1 The authors highlight the important risk of misclassification when MRI-detected sacroiliac joint bone marrow oedema is used to diagnose axial spondyloarthritis as the high sensitivity but insufficient specificity of this finding can lead to overdiagnosis and inappropriate treatment initiation. Their cautionary perspective is timely and warranted. However, we believe that the discussion underemphasises two crucial and emerging aspects: technical advances that increase the reliability of MRI interpretation and the therapeutic implications of early imaging.