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In this lecture, Prof. Denis Poddubnyy provides a concise and insightful overview of how imaging defines the diagnosis and differential diagnosis of axial spondyloarthritis (axSpA). While clinical evaluation sets the stage, imaging ultimately confirms the presence and pattern of inflammation in the sacroiliac joints and spine.
He walks us through recent landmark studies that have shaped current imaging practice, comparing the strengths and pitfalls of X-ray, MRI, and CT. Particular focus is given to the interpretation of MRI findings in their anatomical and biomechanical context—showing why bone-marrow edema alone is insufficient without correlating structural lesions such as erosions, backfill, and ankylosis.
Prof. Poddubnyy also explains how a modern MRI protocol, including an erosion-sensitive GRE sequence, can rival CT accuracy, and why recognizing mechanical stress patterns or anatomic joint variants is essential to avoid overcalling inflammation. The session concludes with a practical, evidence-based workflow for integrating imaging findings into confident clinical decision-making.
After completing this lecture, participants will be able to:
Denis Poddubnyy, MD, PhD, MSc (Epi), is a Professor of Medicine at the University of Toronto.
In 2008, he completed his PhD thesis on cardiovascular pathology in ankylosing spondylitis. In 2013, he completed his postdoctoral thesis (Habilitation) focusing on the prediction and prevention of disease progression in early axial spondyloarthritis. He earned a Master’s degree in Epidemiology from the Institute of Public Health in Berlin in 2016. That same year, he was appointed Professor and Head of Rheumatology at Campus Benjamin Franklin, Charité University Hospital in Berlin, Germany, and served as the leader of the "Spondyloarthritis" research group at the German Rheumatology Research Centre (DRFZ).
In July 2024, he was appointed to a full-time clinical academic position in the Division of Rheumatology, Department of Medicine at the University of Toronto, with the rank of Professor, and as a Senior Scientist at the Schroeder Arthritis Institute of the University Health Network in Toronto, Canada. He serves as Director of the Advanced Imaging Program, and Co-Director of both the Psoriatic Arthritis Program and the Clinical Trial Unit.
Since 2003, his research has focused on the early diagnosis, treatment, and outcomes of patients with spondyloarthritis, including psoriatic arthritis. Dr. Poddubnyy is a member of the Executive Committee of the Assessment of SpondyloArthritis International Society (ASAS) and a member of the Steering Committee, as well as the Research and Publication Committees, of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). He also serves on the Research Committee of the Spondyloarthritis Research and Treatment Network (SPARTAN). He is the author of more than 300 publications, including peer-reviewed journal articles and book chapters.
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