Known case of ankylosing spondylitis underwent left total hip replacement and complains of increasing back pain
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Ankylosing spondylitis is a seronegative spondyloarthropathy (HLA B27 positive) that mainly affects the axial skeleton including the spine and sacroiliac joints. Appendicular skeleton involvement usually occurs at the hip, knee, hands and shoulder. Extraskeletal manifestations include iritis, aortic valve insufficiency, inflammatory bowel disease and upper lobe pulmonary fibrosis.