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Background Axial spondyloarthritis (axSpA) is an inflammatory condition affecting the axial skeleton, which includes the sacroiliac joints (SIJ) and the spine. Common symptoms include back pain which often radiates to the hip/buttocks and morning stiffness that is relieved by exercise. Treatment includes physiotherapy, non-steroidal anti-inflammatories (NSAIDs) or in severe cases with biologic agents. In the UK, patients can access biologics if they are unresponsive to NSAIDs and BASDAI is &amp;gt; 4. Methods Patients under care of a rheumatologist with a diagnosis of axSpA, with an MRI of the axial skeleton, CRP or ESR and BASDAI within 3 months of imaging were included in the study. MRIs (T1 and STIR) of the spine and sacroiliac joints were scored using the ASspiMRI-a (Berlin modified) and SPARCC SIJ methods. Data from a total of between 35-53 patients was used for the project, depending on available data for the scoring method. Due to incomplete data sets for spinal MRIs, the scoring was sub-grouped as follows: - BerlinC2: C2/3 to L5/S1 VU (maximum score 69) - BerlinT1: T1/2 to L5/S1 VU (maximum score 51) - BerlinT10: T10/11 to L5/S1 VU (maximum score 24) Kendall’s tau-b correlation coefficient was used for statistical analysis. The p value of significance was also corrected using the Bonferroni adjustment to 0.00192 due to multiple statistical analysis. Results The median and interquartile ranges for each of the scoring methods were relatively low in relation to the maximum possible score. These were 5(11) for SPARCC, 5(5.5) for BerlinC2, 4.5(8) for BerlinT1 and 3(3) for BerlinT10. The ranges for the collected scores were also low compared to the maximum possible score for each method. These were 0-45 for SPARCC (maximum 72), 0-23 for BerlinC2 (maximum 69), 0-18 for BerlinT1 (maximum 51) and 0-8 for BerlinT10 (maximum 23). A total of 26 correlations were evaluated from 10 variables. These variables were the SPARCC, BerlinC2, BerlinT1, BerlinT10, BerlinC2 + SPARCC, BerlinT1 + SPARCC, BerlinT10 + SPARCC, CRP, ESR. and BASDAI. None of the correlations were significant. Conclusion There was no significant correlation between BASDAI and inflammation as assessed by imaging in axial spondyloarthropathy. The subjectivity of the items of the BASDAI may contribute to this finding and as such, should be a point for further research to assess the suitability of the BASDAI in evaluating disease activity and response to treatment in axial spondyloarthropathy. Disclosures J. Taylor None. N. Gullick None.

P245 Relationship between symptoms and imaging in axSpA