Understanding of the spondyloarthritis diseases has changed significantly in the last 15 years. It is now clear that there are patients with and without radiographic changes and the terminology has changed to reflect that: radiographic axial spondyloarthritis and non-radiographic axial spondyloarthritis. In addition, the importance of the presence of inflammatory back pain with spondyloarthritis in making the diagnosis is now well established. It is also clear that women are much more likely to develop axial spondyloarthritis than previously thought. Finally, there are treatments now available to treat axial spondyloarthritis and more hopefully to be approved in the next year.