Objectives: Disability related to chronic low back pain (LBP) is a complex and multidimensional phenomenon all over the world. The prevalence of backache in middle age and elderly is up to 84%. This study aims to evaluate the associations of X-ray features of lumbar disk degeneration with severity of disability among patients with mechanical LBP. Patients and Methods: A cross-sectional study was conducted on a total of 300 patients with chronic mechanical LBP. Severity of disability was measured using Modified Oswestry Disability Index and intensity of backache was assessed using numeric rating scale (0–10). X-ray features of lumbar disc degeneration according to Lane classification and spondylolisthesis were assessed in lateral recumbent lumbar X-rays. Results: The mean age of our sample was 52.45±7.87 and 71.7% of involved patients were women. Most patients were recorded as overweight or obese. The findings of disk space narrowing were mild in 65.7%, moderate in 28.7%, and severe in 5.6%, where the presence of osteophytes were small in 76.9%, moderate in 20.5%, and large in 2.6%. Regarding disability, two-third of cases were focused on minimal disability, followed by moderate, severe, and crippled as (26%), (6%), and (2%), respectively. There was highly significant association between women and pain radiation to legs (p=0.004). Obesity and overweight had meaningless effects on all markers. Conclusions: The severity of disability was significantly more in women, high intensity of lower back pain, presence of pain radiating to legs, moderate/severe disk space narrowing on X-ray, and disk degenerative disease score on X-ray, while age, presence of osteophytes and spondylolisthesis, body mass index, and pain duration were not associated with severity of disability.

Objective: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy commonly associated with psoriasis, a large number of patients with PsA that has persistent inflammation may develop progressive joint damage and disability and have reduced life expectancy. This study aims to determine the associations of anti-cyclic citrullinated peptide (CCP) antibodies in adult patients with psoriasis and PsA.Methods: A case–control study was conducted at Baghdad teaching hospital, Units of Rheumatology and Dermatology, during the period from December 2016 to April 2017 including three groups; 40 patients with psoriasis, 40 patients with PsA fulfilling the CASPAR classification criteria, and 40 healthy control persons.Results: Two patients with psoriasis (5%) and 10 patients with PsA (25%) were seropositive for anti-CCP antibodies (ACPA). Healthy controls were negative for anti-CCPA. Regarding ACPA positivity, a significant difference was found between those three studied groups (p<0.001) and there was a significant difference between positive and negative ACPA in PsA patients regarding disease activity score (p=0.044).Conclusion: Positive ACPA were found more significant with PsA than in patients with psoriasis as well as associated with higher disease activity.

Diffuse idiopathic skeletal hyperostosis is a non-inflammatory disease characterised by calcification of soft tissues, mainly ligaments and enthuses, as well as by ossification of the anterior longitudinal ligament. To assess the relationship between Metabolic Syndrome and Diffuse Idiopathic Skeletal Hyperostosis among a sample of middle and old age Iraqis.A cross-sectional study was conducted from October 2018 to May 2019 at the Rheumatology Unit of Baghdad Teaching Hospital, Iraq and Basra Teaching Hospital, Iraq. A total of 282 patients were included in the study. Data were gathered using a pre-constructed data collection sheet for patients that evaluate: age, gender, occupation, education, smoking, weight, height, waist circumference, and body mass index were calculated. Clinical data about back pain, limitation in movement or any neurological symptoms were identified, serum lipid profiles (serum triglycerides, serum high-density lipoprotein), fasting blood sugar, haemoglobin A1c and serum uric acid were obtained. Diffuse Idiopathic Skeletal Hyperostosis was reported in 18 (6.4%) patients. High waist circumference was reported in 175 patients, high triglycerides found in 208 patients, while low HDL found in 162 patients. We reported 147 patients who had elevated blood pressure and 106 patients with elevated blood glucose. Diffuse Idiopathic Skeletal Hyperostosis was significantly more frequent in patients with metabolic syndrome compared to those with no metabolic syndrome, (9.2%) vs (3.1%). There is a significant association between diffuse idiopathic skeletal hyperostosis and metabolic syndrome among a sample of middle and old age Iraqi people.

Ankylosing Spondylitis is a chronic, progressive inflammatory rheumatic disease that involves primarily the sacroiliac joints and the axial skeleton. Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability and poor quality of life. The study aimed to assess the prevalence of sarcopenia in patients with ankylosing spondylitis. A case-control study was conducted at Rheumatology Unit from January 2019 to July 2019. The study population consisted of 50 Iraqi patients diagnosed with AS and 50 healthy control. Demographic data, physical activity using General Practice Physical Activity Questionnaire (GPPAQ), disease activity scores using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were recorded. Sarcopenia assessment was done by using a dual-energy x-ray absorptiometry scan for body composition analysis and measuring skeletal mass index (SMI). The maximal voluntary grip strength of the hand was measured with an electronic dynamometer. Physical function was assessed by a 4-meter usual gait speed test. The prevalence of presarcopenia was 6% in both studied groups, while sarcopenia was 10% in AS patients. The mean value of BMI is significantly lower in patients with sarcopenia than in those without (p=0.001). The vast majority of the sarcopenic group (80%) were physically inactive which was statistically significant compared with the non-sarcopenic group (p=0.033). No significant association of treatment with anti-TNF or its duration was found between sarcopenia and non-sarcopenia groups (p=0.377; p=0.187). Both LM and handgrip showed fair validity to differentiate between AS patients and controls. Patients with AS are at higher risk of developing early sarcopenia than in healthy controls. Lower BMI and longer disease duration increase the risk of sarcopenia, while differences in gender, smoking and the use of anti-TNF do not influence the risk. Physical activity may improve muscle strength and perhaps decrease the risk.