A 59-year-old right-handed man with AS (diagnosed at age 19 years) and osteoarthritis of the right hip was referred to our physical medicine and rehabilitation service for evaluation of leg length discrepancy (LLD). The patient reported that he had been informed of his LLD when he was in his 20s, but he had not received orthotic treatment. At the time of presentation, he was receiving celecoxib, prednisone, and infliximab (infused every 6 weeks), all prescribed by another physician. Despite prior treatment, the patient still described increased pain, particularly in his right hip, during golfing, yard work, and other activities of daily living. The patient also reported numbness in his right thigh that made it difficult for him to stand for long periods. In addition, the patient noted that before urinating, he would have to engage in a compensatory postural modification. Specifically, he would bend his right knee and push himself up on his right toe in an attempt to even out his leg lengths so that he could urinate in a stable fashion.