Lee KH, et al. - In this prospective study, researchers examined how apparent diffusion coefficient (ADC) at MRI of discovertebral lesions is associated with disease activity in individuals with axial spondyloarthritis (SpA). They analyzed 243 study participants (mean age ± standard deviation, 43.2 years ± 13.5) with back pain who fulfilled the Assessment of SpondyloArthritis International Society criteria for SpA from four rheumatology centers between April 2014 and March 2018. Of these, 55 participants (22.6%) presented 91 discovertebral lesions (five cervical, 61 thoracic, 25 lumbar). Increased maximum ADC was noted to be independently associated with increased Bath Ankylosing Spondylitis Functional Index after adjusting for confounding factors. Independent association of increased normalized maximum ADC with Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] question 2 (ie, back pain score), mean stiffness score, and Bath Ankylosing Spondylitis Global Index was also evident. These findings demonstrate the association of apparent diffusion coefficients at MRI of discovertebral lesions with disease activity, functional impairment, and patient global assessment in axial spondyloarthritis.