A hot, swollen joint without trauma: septic arthritis until proven otherwise.

To cite: Oliveira AS, Abbasi F, Radha SS. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014209190 DESCRIPTION A 71-year-old man with a history of rheumatoid arthritis presented to the accident and emergency department with a hot, swollen and painful right knee. The patient had been seen by his primary care physician several times in the preceding 4 months, and each time oral antibiotics and non-steroidal anti-inflammatory drugs were prescribed for presumed pre-patella bursitis. There was no history of joint surgery or intra-articular steroid injection and rheumatoid disease was currently well controlled with sulfasalazine. At presentation, the patient’s temperature was 38.4°C, and there was a moderate effusion and