Structural degenerative changes of the spine are the most common causes of axial and radicular pain. Accurate diagnosis is important for making treatment decisions, improving quality of life, and controlling health care costs. Imaging is critical in the evaluation of patients with spine-related disability and the diagnosis of pain generator. However, morphological abnormalities frequently occur in both symptomatic and asymptomatic individuals. This article reviews relevant spine anatomy and nomenclature related to degenerative abnormalities. It also addresses imaging findings in inflammatory spondyloarthropathy.