Ankylosing spondylitis is a chronic inflammatory bone disease that commonly affects the spine and the sacroiliac joints. Ankylosing spondylitis can also cause enthesitis, or enthesopathy, which is an inflammation at the tendinous or ligamentous insertion sites on the bones. In this study, we present the case of a 37-year-old man with ankylosing spondylitis with a unique Tc-HDP bone scan finding of symmetrical increased uptake bilaterally in the greater trochanters.