Rapidly destructive coxarthrosis of the hip joint is a rare condition of which the etiology and pathogenesis are poorly understood. Ordinary arthrosis or osteoarthritis of the hip joint usually occurs over long duration with well-established risk and predisposing factor in the elderly. However, rapid destruction may occurs over a period of a few months’ damaging the acetabulum and femoral head. Various mechanism has been reported in previous literatures which implicates both subchondral insufficiency and autoimmune related. We report a 36-year old Indian woman with progressive left hip pain as early symptoms of rheumatoid arthritis with negative rheumatoid factor and positive anti-citrullinated peptide antibody, supported by the magnetic resonance imaging and synovial histopathological findings. There was only one similar case reported in the literature and more than eight cases with pre-existing rheumatoid arthritis occurring in patients of more than 50 years of age.