A 38-Year-Old Man Comes to the Office with a 6-Week

A 38-year-old man comes to the office with a 6-week history of progressive right hip pain.  He localizes the pain to the right groin and says that it is present at rest and worse with weight bearing.  The patient has no history of trauma and has not had similar symptoms before.  Medical history is notable for sarcoidosis, which has required extended courses of oral glucocorticoids.  His temperature is 37.2 C (98.9 F) and blood pressure is 156/86 mm Hg.  On examination, the patient's face is round and there is fullness in the supraclavicular area.  Forced abduction and internal rotation of the femur aggravate the pain.  Muscle power is slightly decreased in the proximal thigh muscles in both legs.  Reflexes are 2+ throughout, and there are no sensory deficits.  Plain films of the right hip show no significant abnormalities.  Which of the following is the most likely cause of this patient's hip pain?

A) Bacterial infection of the joint
B) Degeneration of articular cartilage
C) Disruption of bone vasculature
D) Inflammation of the trochanteric bursa
E) Monosodium urate synovitis

Correct Answer:

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