Case presentation A 14-year-old boy presents with a recent history of tender temporomandibular joints and regular morning stiffness in both hips. He has limited movement range in his hips, particularly abduction and adduction, and can no longer run and play with his peers. C-reactive Protein, ESR, WBC, and Hb tests were normal.
Further investigations Rheumatoid factor: Negative HLA B27: Positive X-rays: Showed the beginning of fusion of sacroiliac joints and early signs of destruction of the left hip joint.