Conventional radiographs are usually the initial diagnostic studies ordered for inflammatory musculoskeletal lesions, such as those seen in inflammatory osteoarthropathies. However, the sensitivity of radiography is low, which may result in missed or delayed diagnoses. Cross-sectional imaging modalities, predominantly MRI, have been used in the diagnostic workup of patients with a suspected or established diagnosis of an inflammatory osteoarthropathy with variable success. Contrast-enhanced MRI provides valuable information by identifying abnormal enhancement of the synovial sheaths in inflammatory arthropathies. However, the sensitivity of MRI is also not optimal, and early stages of disease can be easily missed. With the advent of modern biologic therapeutic agents that decrease the progression of systemic inflammatory processes, early diagnosis of inflammatory disorders of bones and joints is all the more critical. The utility of PET in the assessment of joint inflammation, both in the initial diagnostic workup and subsequent monitoring of response to therapy in patients with different inflammatory arthropathies, has been investigated by several groups.