A 65-year-old male with a long-standing history of rheumatoid arthritis presents with sudden onset of fever, chills, and pain in his right hip. On examination, his right hip is swollen, red, and tender to touch. What could be the cause, and what are the next steps?
In a patient with rheumatoid arthritis, an acutely painful, swollen, and red joint could indicate septic arthritis, a serious condition where a joint becomes infected. This is particularly concerning in patients with rheumatoid arthritis, as they may be immunocompromised due to their disease or its treatment. The patient should be promptly evaluated with joint fluid analysis to confirm the diagnosis and identify the causative organism. Urgent orthopedic consultation is needed as septic arthritis is often managed surgically, in addition to antibiotics.