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Radiographs and magnetic resonance imaging (MRI) are both used to screen for and diagnose axial spondyloarthritis (axSpA) but they also provide information about morphological and even biomechanical changes in the spinal components. The natural course of degenerative changes in the spine over a long period of observation has not been established in a large group of patients with axSpA. Moreover, it is not well-known which factors are associated with faster progression.

To investigate the evolution of degenerative spinal lesions in patients with axSpA over 10 years (10Y) of follow-up and the factors associated with progression.

Whole spine MRI and cervical and lumbar spine radiographs at baseline, 2Y, 5Y and 10Y of patients diagnosed with axSpA in the DESIR cohort were assessed for degenerative lesions by 3 central readers blinded to timepoint and to clinical or any …