Document Type : Original Article


1 Ministry of Health, Sulaimani, Kurdistan Region, Iraq

2 Sulaimani Medical school, University of Sulaimani, Kurdistan Region, Iraq



Background: The risk of fractured vertebral increases in patients with rheumatoid arthritis as they are more likely to suffer from osteopenia, and osteoporosis.
Objectives: This study aimed to investigating the rate and risk factors of vertebral fractures in patients with rheumatoid arthritis.
Methods: We recruited 201 patients aged between 30 and 70 who attended the rheumatology department at Shahid Hemn Teaching Hospital in Sulaymaniyah, between January and September 2022. Medical records were reviewed for disease and treatment characteristics while also clinically evaluated by a rheumatologist. Spinal radiographs were assessed by two experienced radiologists blinded to patients’ clinical diagnosis and status. Compression fractures were classified by using the Genant semiquantitative method, and the type of fracture was classified as wedged fracture, biconcave fracture, or crushed fracture.
Results: Of the 201 included participants, 151 were female, and 50 were male. The BMI of women was higher than men by nearly four points (P<0.001). Most women were also illiterate (68/151, 45.0%) and unemployed (139/151, 92.1%). Hypertension (28.4%) and diabetes mellitus (14.4%) were the most reported comorbidities. Women were more likely to have higher DAS28 scores while men had more vertebral fractures (P=0.003). The probability of fractures increased with age, male sex, and illiteracy compared to primary school, osteopenia, and osteoporosis through simple and multiple logistic regression models.
Conclusion: With at least one fracture affects females and males at a rate of 27.8% and 52.0%, respectively. Also reported that age, male sex, illiteracy, osteopenia, and osteoporosis significantly increase the risk of fractures.