الفهرس 
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Abstract
The objective of this work was to determine the prevalence of chronic pain, fatigue, depression, and sleep disturbances and how these patient-reported outcomes impact the general quality of life.
The study was conducted on forty patients with axial SpA in an outpatient setup for a period of six months, diagnosed based on Assessment of Spondyloarthritis International Society (ASAS) criteria. Patients with autoimmune diseases or major chronic illnesses like cancer and liver disease were excluded. A comprehensive history taking, physical examination of both general and musculoskeletal targeted examination, and assessment of disease activity using Bath Axial SpA Disease Activity Index (BASDAI), axial SpA disease activity score (ASDAS), Bath Axial SpA Functional Index (BASFI)) were applied to all patients.
Complete blood count (CBC), Acute phase reactants (Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and Serum HLA-B27 status were determined on the first encounter. All patients were subjected to either an x-ray or MRI depending on the findings of initial x-ray imaging and clinical findings.
The study revealed that pain was the most prevalent complaint among the study subjects., patients with moderate to severe pain on a visual analog scale had poor quality of life: were more fatigued, and had elevated CRP and ESR with a statistical significance of P values of (0.019, 0.006, and 0.005). The subjects in our study did not report sleep disturbance. In our study, 17.5% had symptoms that suggested a diagnosis of fibromyalgia. chronic widespread pain was carefully sorted in those with fibromyalgia-like symptoms and were grouped separately.
In the present study, fatigue was the second most common complaint. we demonstrated that 55% of patients with axial SpA had fatigue and we evaluated using BASDAI’S first item. The majority of the subjects who complained of fatigue from this study were male contrary to other larger studies that found females were affected more by fatigue. from our results, there was a significant correlation between fatigue and ASDAS and BASDAI as well as RAPID 3 scores with P values of (0.008, 0.032, and 0.001 respectively) this revealed a significant impact of fatigue on mobility, usual activities, perceived stress test, hospital anxiety