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In many but clearly not all cases of axSpA new bone formation in form of syndesmophytes and ankylosis occur in the further course of the disease. Function and mobility may be impaired by both, inflammation and structural changes. In clinical trials outcome parameters most often used refer to pain, disease activity, function, mobility and global health but many researchers are also interested in radiographic progression in the axial skeleton of patients with axSpA. This viewpoint discusses the relevance of structural changes in the SIJ in comparison to the spine and in relation to functional outcomes and mobility.<\/jats:p>","DOI":"10.1136\/rmdopen-2022-002822","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T09:57:58Z","timestamp":1671011878000},"page":"e002822","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Significance of structural changes in the axial skeleton in patients with axial spondyloarthritis: how important are lesions in the sacroiliac joint?"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9156-5095","authenticated-orcid":false,"given":"Juergen","family":"Braun","sequence":"first","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr Universit\u00e4t Bochum, Herne, NRW, 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