A 36-year-old woman presented to the emergency department with right h
ip pain of one week's duration. An x-ray of the hip was unremarkable.
She was diagnosed with trochanteric bursitis, given ibuprofen (800 mg
tid) and crutches, and sent home. The next day, continual pain and pro
gressive functional impairment prompted her to see an orthopedist. He
concurred with the initial diagnosis and administered a corticosteroid
injection into the right trochanteric bursa. Propoxyphene (65 mg q4h
prn) was added to her medical regimen, and she was again sent home. Pa
in developed in the right sacroiliac area the next day. Within 24 hour
s, the right shoulder and right sternoclavicular joint were also invol
ved, and the patient began having subjective fever and chilliness. She
returned to the orthopedist and was immediately referred to a rheumat
ologist who ordered blood cultures and admitted her to the hospital.