The prevalence of joint hypermobility among 1774 university students, aged 20-24 years, in Iraq has been determined from a survey made in 1981. The degree of joint hypermobility was scored on a scale between 0 and 9 using the method described by Beighton in his modification of the Carter and Wilkinson scoring system. Joint hypermobility, defined as a score of 4 out of 9 or greater was found in 25.4% of males and 38.5% of females. The presence of joint complaints, ligamentous sprains, flat feet, Raynaud's phenomenon, easy bruising, high palate and varicose veins correlated well with joint hypermobility and were seen significantly more frequently in students scoring 7 out of 9 or more than in students scoring 3 out of 9 or less. The right (usually dominant) side was significantly less mobile than the left side, whatever the hypermobility score. Physique as expressed by body weight and height did not show any relation to joint mobility.

In order to assess a possible role of the natural glutathione defense system in the pathogenesis of rheumatoid arthritis (RA), serum reduced glutathione levels (GSH), glutathione reductase (GSR), glutathione S-transferase (GST), glutathione peroxidase (GSH-Px) and alkaline phosphatase (ALP) activities, lipid peroxidation (MDA content) and indexes of inflammation were evaluated in 58 rheumatic patients. Rheumatoid athritis was associated with significant depletion (ca. 50%) in GSH levels compared with normal control subjects. Serum levels of the detoxifying enzymes GSR and GSH-Px decreased by ca. 50% and 45%, respectively, whereas a threefold increase in the activity of GST was observed. A 1.2-fold increase in ALP was observed in patients with RA. These effects were accompanied by a 3.1-fold increase in serum MDA content. The MDA content was higher in RA patients who were seropositive for rheumatoid factor as well as positive for C-reactive proteins. The erythrocyte sedimentation rate for all patients with RA was approximately 13.8-fold higher than for the control group, and was higher among RA patients who were positive for C-reactive proteins and exhibited seropositivity for rheumatoid factor. Patients with RA receiving gold therapy exhibited significantly lower MDA levels whereas all other factors that were measured were not effected. The results support a hypothesis that defense mechanisms against reactive oxygen species are impaired in RA.

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The relationship between joint mobility and chondromalacia patellae was reported in a prospective study. A total of 115 patients with chondromalacia patellae were compared with 110 healthy individuals without chondromalacia patellae, matched for age and sex, who served as a control group. The degree of joint mobility was scored on a scale of 0±9. The number of individuals with hypermobile joints and the total mobility scores were signi®cantly higher in patients with chondromalacia patellae when compared to the control group (P<0.001). There were more hypermobile knees among knee joints with chondromalacia patellae when compared with the knees of the control group (P<0.01). Chondromalacia patellae were bilateral in 57% of our patients. It occurred more frequently in the longer leg and was associated with quadriceps muscle wasting in 50% of patients. Flat feet and backache were reported signi®cantly more often in patients compared with the control group (P<0.05). It is concluded that hypermobility of the knee joint may be a contributing factor in the pathogenesis of chondromalacia patellae.