A 64-year-old man was referred to our rheumatology clinic for preoperative assessment prior to cataract surgery. He was diagnosed with ankylosing spondylitis (AS) 16 years earlier; however, treatment was discontinued owing to nonsteroidal anti-inflammatory drug-induced gastric ulcer bleeding 10 years ago. He had persistent back pain with stiffness and stayed at home in a bedridden state for several years. On physical examination, both hip joints were fixed in the flexion state, and both hand and wrist joints had severely limited motions. Laboratory examination revealed the following: C-reactive protein level, 0.90 mg/dL (normal range, 0.0 to 0.5); erythrocyte sedimentation rate, 120 mm/hr (normal range, 0 to 20); negative findings for the rheumatoid factor and anti-citrullinated protein antibody; and positive findings for human leukocyte antigen-B27. Radiography showed bamboo spine and ankylosis of the sacroiliac and hip joints (Fig. 1). Total ankylosis in most hand and wrist joints is shown in Fig. 2.