This 44 yr old lady presented with sacroiliitis in the context of a recent diagnosis and treatment for breast cancer. She went on to develop a widespread joint disease similar to Ankylosing Spondylitis (www.nass.co.uk). I tried all treatments including numerous complex immune suppressing therapies without achieving control. Oral steroid and injection into joints were helpful, though the injections short lived. She developed a rare eye complication to steroid so this treatment had to be stopped. At this point there were no real options (TNF inhibitors are excluded by the prior malignancy). Continue reading