This report presents interim results from a series of studies of the lumbosacral region of the spine. A new classification of the lumbosacral transitional vertebra (LSTV) is proposed. An LSTV was found with similar frequency in patients and in population samples. The radiological findings were related to the presence of symptoms and to evidence of urological problems. Whilst Brocher (1973), Rubin (1971), and others have considered an LSTV to be of importance because it should lead to unfavourable weight bearing in the lower spine, the present extensive material shows that there is no relation between an LSTV and low backache. There may be a genetic factor involved in the various types of LSTV.

Heberden Society 199 biopsy was normal in 35 % of investigations, while reactive hepatitis was seen in 43 % and fatty liver in 22 %. Reactive hepatitis was mild in 6 %, moderate in 15 %, and severe in 22% of biopsies; fatty liver was mild in 11 %, moderate in 7 %, and severe in 4% of specimens. An abnormal BSP test was observed in 75 % of investigations, raised alkaline phosphatase in about 50%, an abnormal thymol turbidity test in 24 %, and diminished prothrombin (Quick) in 20%. A rise in transaminases in serum and in urobilinogen in urine was, however, very rare. A rise in bilirubin (more than 1-0 mgll00 ml) was never observed. There was a close relationship between rheumatoid arthritis activity and abnormal BSP retention, raised alkaline phosphatase, and reactive hepatitis. These tests, however, were not correlated to duration or stage of arthritis nor age of patients. These data were obtained in West Germany. In a second series in Switzerland, liver function tests, as well as liver biopsies, were carried out in 51 patients with definite rheumatoid arthritis. BSP retention was abnormal and prothrombin in 60 % of cases, alkaline phosphatase in 20%, thymol turbidity test in all 25 patients examined. Slightly raised levels of transaminases were seen in about