Renson R, Carron P, De Craemer AS, et al. - In this study, the axial involvement on MRI was evaluated in early peripheral spondyloarthritis (pSpA) and to assess if axial inflammation predicts relapse on treatment withdrawal. Researchers included a total of 56 patients with early, active, newly diagnosed peripheral spondyloarthritis (pSpA) who had undergone MRI of the sacroiliac joints (SIJs) and spine prior to golimumab initiation. They evaluated the fulfillment of the Assessment of Spondyloarthritis International Society (ASAS) definition of a positive MRI for sacroiliitis. They further assessed spinal images for BME and structural lesions applying the Canada-Denmark MRI spine scoring system by two readers. This study’s findings revealed that in individuals with early pSpA, a surprisingly high prevalence of sacroiliitis on MRI was found; Spondyloarthritis Research Consortium of Canada scores reduced significantly on tumor necrosis factor inhibition. It was shown that the residual inflammation on MRI was not predictive of relapse of peripheral manifestations. No relevant inflammatory spinal involvement was diagnosed. The data imply a higher inflammatory burden in individuals with early pSpA than anticipated.