TNF and bone inflammation disease: Therapy-wise, disease-modifying antirheumatic drugs (DMARDs) were used in 21 of 31 patients: 8 received conventional synthetic DMARDs, and 11 received biologic agents (8 anti-tumor necrosis factor agents, 3 interleukin-17 inhibitors), whereas the remaining 10 patients were treated with ≤10 mg/day of GCs.<h4>Conclusion</h4>Late-onset SpA with PMR clinical presentations is characterized by failure to respond to or taper GC therapy and is often identified by SpA-specific osteitis patterns on MRI.