SUMMARYWe describe a 65‐year‐old male who presented with unilateral sacroiliitis as the first manifestation of metastatic prostatic carcinoma. When progressive symptoms are unresponsive to conventional therapy, a reconsideration of the diagnosis is necessary with appropriate further imaging studies. We discuss the differential diagnosis of sacroiliitis including, mechanisms of joint involvement in malignancy, and present a review of the literature.
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