الفهرس 
Patients and methodsOnly 14 pages are availabe for public view
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Abstract
SUMMARY AND CONCLUSION
This study was carried on 45 patients attending the outpatients
clinic of rheumatology and Rehabilitation Departmetns of
Benha and Cairo university hospitals they were classified into
three groups.
Group! :-
Rheumatoid arthritis patients with low back (n = 15).
Group!! :-
Rheumatoid arthritis patients without low back pain (n=15).
Group!!! :-
Comprising 15 patients complaining of chronic low back
pain of more than three months.
One Hundered patients with RA were questioned about the
symptom of back pain. Chronic back pain lasting more than 3
months,occured in 15 percent and they were considered as group 1.
The three groupSof patients were studied in more details by
clinical examination and radiology.
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~~-------- Results of the clinical study of group I, and group 11,as
regards the mean articular index was statistically signifcant
between both group (P < 0.05). As well as the duration of the
RA disease (P < 0.02).
In group I, 10 patients had low back pain while 5 patient had
upper and lower back pain,particular clinical patterns (such as that
of the facet syndrome) were sought but therewas no correlation
between the radiological and the clinical findings.
Results of the physical examination of the lumbar spine of
the 3 groups revealed:
A signifioant difference was detected between group I and
II,(P < 0.05) as regards the mean of spinal flexion and the mean
extension in group I and II, also showed significant difference
between both groups (P<0.05).
Fifteen lumbar spine X-ray were available from the RA with
low back pain and these were compared to age and sex matched
X-rays of both RA group and low back pain group. Significant
differences between these three groups radiologically were a
higher frequency of osteoporosis and higher frequency of disc
narrowing without associated osteophytes, vertebral fracture in the
RA with low back pain paitents.
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This study differes from previous reports which found other
characteristic radiological changes of RA of the lumbar spine as
facet erosions.A discrepancy possibly resulting from the use of a
control group having low back pain.
from our study we conclude that arthritis is less frequent in
the lumbar spine, is more difficult to rcognize or both.
Almost 15% of our patients were suffereing from chronic
low back pain, the cause of this pain is likely to be multifactorial
including facet joint synovitis, crush fracture associated with
osteoporosis, gait abnormalities associated with lower limb joint
involvement, the effect of steroids on ligament laxity and muscle
bulk and, occasionally spondylolisthesis associated with inflammatory
changes.
Our study does not entirely support prevIOUS work
characterizing radiological involvement of the facet joints of the
lumbar spine in RA.
We recommend further invistigation of the lumbar spine in
RA using more specialized views or C.T.