HSPD1 and osteoarthritis: This case highlights: 1) Herbal steam therapy, degenerative joint disease, and prior interventions as underrecognized risk factors; 2) Rapid molecular diagnostics (MALDI-TOF MS/<i>hsp65</i>) critical for early diagnosis; 3) Short-course oral therapy (clarithromycin/linezolid) as a potential option for localized infection when prolonged therapy is impractical.