Key Clinical MessageVertebral fractures can be a form of first manifestation of Axial Spondyloarthritis. Additionally, Radiofrequency Echographic Multispectrometry is a valuable tool in the asessement of bone mineralization and architecture, due to it’s fast, non-irradiating and precise measurements. Methotrexate represents a viable alternative to Sulfasalazine for management of AxSpA.