Fifty-nine–year-old Ray is complaining of a nagging discomfort in his buttocks and hips. It started about 6 weeks ago and is now interfering with his sleep. Ray says that when he lies down, the discomfort gets worse, so he often gets up in the middle of the night to walk around to get relief. He also describes a sciatic-like pain that occurs intermittently but states, “it goes from one side to another” .

How is the inflammatory response associated with this skeletal disorder?
If Ray starts to complain of similar symptoms in other joints, what will you need to consider?

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