Rice Bodies Research Articles

Recurrent granulomatous synovitis due to Mycobacterium kansasii in a renal transplant recipient

A 61-year-old woman received a cadaveric renal transplant in 1972 and was maintained on chronic immunosuppression. Nonspecific granulomatous synovitis of the left hand developed in 1982. After recurrence of synovitis in 1984, surgical exploration of the left hand demonstrated "rice bodies" in a region of chronic synovitis from which Mycobacterium kansasii was isolated. Despite therapy with isoniazid, rifampin, and ethambutol, to which the organism was susceptible in vitro, synovitis recurred. Recovery was completed after extensive synovectomies, decreased immunosuppression, and 24-months of therapy, with the drugs listed above; there was no evidence of mycobacterial infection at sites other than the left hand at any time. The occurrence of persistent Mycobacterium kansasii infection is distinctly unusual even in transplant recipients. In patients refractory to conventional antituberculous therapy, surgical management should be considered as an important therapeutic component.

結核性肩峰下滑液包炎と思われた１症例

A 42-year-old male visited our department because of swelling and limitation of ROM on his right shoulder. At the consultation, soft tissue tumor or subacromial bursitis were suspected.The soft tissue tumor was eliminated by further examination including CT-scan, echo and angiography upon hospitalization.During the operation, many rice bodies and a large necrotic mass were recognized. Histological findings of the above tissue didn't deny the possibility of tuberculous lesion.The diagnosis of tuberculous bursitis, which is very rare, was made according to the above findings and positive tuberculous reaction of his skin.After the operation, anti-tuberculosis medication was begun.Four months later, his symptoms had decreased remarkably.

Effects of joint lavage on knee synovitis in rheumatoid arthritis.

Ten patients with rheumatoid arthritis and persistent knee synovitis had synovial fluid aspirated through a 14 gauge wide-bore needle followed by joint lavage and intra-articular triamcinolone. This resulted in the removal of variable quantities of intra-articular debris including rice bodies. When compared to a control group of patients, the addition of joint lavage to the standard procedure of aspiration and injection of corticosteroid resulted in more sustained resolution of synovitis after 12 weeks as judged by knee tenderness and circumference, recurrence of effusion, and synovial fluid leucocyte count. This study suggests that knee joint lavage may be a useful adjunct to therapy in rheumatoid arthritis patients having persistent knee synovitis.

Frequency of occurrence, mode of development, and significance or rice bodies in rheumatoid joints.

The incidence of rice bodies (RB) in synovial effusions has been studied in 36 patients with rheumatoid arthritis (RA) and in 12 patients with seronegative inflammatory arthritis (7 cases of Still's disease, 3 of psoriatic arthritis, and 2 of ankylosing spondylitis). In the RA group 50 joints were aspirated before and after saline lavage with a specially designed wide-bore needle. RB were found in 72% overall of the joints studied in this group, 14% on initial simple aspiration and an additional 58% after lavage. In contrast no rice bodies were found in 31 aspirations with lavage by an identical technique in the 12 patients with seronegative synovitis. The RB in RA synovitis occurred both early and late in the course of the disease and were not related to the severity of clinical or radiological changes. However, removal of rice bodies was accompanied by clinical improvement and reduction of synovitis. Macroscopically RB varied in shape and size, some being so large as to preclude effective removal by needles of the gauge customarily employed for joint aspirations. Microscopically the majority of RB were composed of coarsely reticular material reacting immunologically with antifibrinogen and antifibronectin and containing mononuclear cells. Some showed vacuolation suggestive of fibrinolysis, but many showed organisation like that seen in established connective tissues, with the formation of mature collagen, reticulin, and elastin. These findings are discussed in relation to the origin, development, and significance of rice bodies in rheumatoid synovitis.

Corpora oryzoidea (Reiskörperchen)*

Light and electron microscopic findings on rice bodies of a patient with rheumatoid arthritis are described. The extracellular material consisted of fibrin and small collagenous fibers. Superficial cells were predominantly macrophages, however, connective tissue cells with rough endoplasmatic reticulum were present. In the central areas neutrophilic granulocytes and connective tissue cells were observed. It is assumed that the connective tissue cells are derived from synovial fluid monocytes that have transformed in collagen synthesizing cells.

Synovial origins of Rice bodies in joint fluid.

Rice bodies and synovia obtained from knee joints of rheumatoid arthritis patients were solubilized by limited pepsin treatment. The quantity of each type of collagen in both tissues was determined by differential salt precipitation, cyanogen bromide peptide analysis, and SDS polyacrylamide gel electrophoresis. Rice bodies and synovial membrane contained equal proportions of Type I and III collagens with trace amounts of Type "A-B" collagen.

Juvenile rheumatoid arthritis with rice bodies: light and electron microscopic studies.

Rice bodies obtained from a young man with juvenile rheumatoid arthritis were found by light and electron microscopy to contain cells that appeared viable. The majority of these cells closely resembled type B synovial lining cells. Type A-like cells were also seen. The cells contained few mitochondria but often much lipid and glycogen, observations which suggested a dependence on anaerobic metabolic pathways in the avascular synovial fluid environment. Cells within the rice bodies lay in a matrix of collagen fibres, fibrin, and amorphous material. The source of the collagen appeared to be the cells themselves. The relatively normal appearance of the cells suggested that they were protected from many of the inflammatory stimuli present in rheumatoid synovia. This 'reversion' towards a normal appearance suggested that the stimuli inducing chronic rheumatoid inflammation might not originate in the synovial lining.

On the Nature of Rheumatoid Rice Bodies

The nature of rice bodies was studied, utilizing histochemistry, immunofluorescence, and scanning and transmission electron microscopy. Rice bodies were found to consist primarily of fibrous material, most of which was fibrin with small amounts of collagen. Channels containing a variety of viable cells permeated the rice bodies. Blood vessels occurred in a few rice bodies indicating a former connection with the synovial membrane. Nonvascularized rice bodies might represent a further degeneration of the vascular type. Rice bodies seem to be a nonspecific response to inflammation.

Valvular mechanisms in antecubital cysts of rheumatoid arthritis.

AbstractTwo further cases of antecubital cysts resulting from rheumatoid arthritis are reported, both having valvular mechanisms permitting synovial fluid to pass from the elbow joint to the cyst but not the reverse. Rice bodies and synovial villous proliferation act as ball‐valves and the long neck of some cysts may act as Bunsen valves. One synovial cyst was successfully excised, while another underwent spontaneous regression after successful surgery at the wrist restored more nearly normal prontation and spination of the forearm.

Tuberculous Tenosynovitis A report of four cases of tuberculous tenosynovitis of the hand

There are few reports on tuberculous tenosynovitis, but probably many sergeons encounter with the disease.We treated four cases of tuberculous tenosynovitis of the hand.Case 1. 35 aged male; Patient has had suffered from swelling and pain in the left middle finger for a year. He received curattage and removal of granulation tissues from the synovial tendon sheath. Tuberculous bacilli cultured from the specimen.Case 2. 21 aged male; Patient was injured in the left hand at the sea, followed by swelling and pain in the dorsum of the hand. He had curattage eight times for two years.Case 3. 59 aged male; He has had swelling and pain over the volar surface of the left forearm for one and half year. Many rice bodies were found at surgery in the tendon sheath.Case 4. 43 aged female; She has noted swelling and pain in the right ring finger for a year. At operation watery seropurulent fluid was found in the flexor tendon sheath of the ring finger.Frequently the correct diagnosis is not made for many months or even years because of the slow developement of the symptomes. The presence of a chronic dough-like sausageshaped swelling over the flexor or extesor tendons is practically always due to tuberculosis, and if rice bodies can be demonstrated the diagnosis is practically certain.The operative treatment with anti tuberculous drags are considerate the best.

A biochemical and electron microscopy study of rice bodies from rheumatoid patients.

AbstractRice bodies (corpora oryzoidea) from rheumatoid patients were studied biochemically and by electron microscopy. The data indicate that only a relatively small portion of the rice bodies is identical to fibrin, and the bulk is composed of other fibrinlike mucoproteins and a small amount of lipids. Some lipids and neuraminic acid are located on the surface. The recurrence of rice bodies is prevented by synovectomy. Fibrous rice bodies represent an end product of synovial inflammation, proliferation, and subsequent secondary degeneration.

TREATMENT OF TUBERCULOUS SINUSES AND ABSCESSES OF OSTEOARTICULAR ORIGIN

The Journal of Bone and Joint Surgery. British volumeVol. 39-B, No. 2 Clinical StudiesFree AccessTREATMENT OF TUBERCULOUS SINUSES AND ABSCESSES OF OSTEOARTICULAR ORIGINB. Mukopadhaya, N. K. MishraB. MukopadhayaSearch for more papers by this author, N. K. MishraSearch for more papers by this authorPublished Online:1 May 1957https://doi.org/10.1302/0301-620X.39B2.326AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited ByRole of local streptomycin in prevention of surgical site infection in TB spine9 January 2020 | European Journal of Orthopaedic Surgery & Traumatology, Vol. 30, No. 4Tuberculosis of Bones and Joints of the Foot: An Analysis of 22 Cases17 November 2016 | Foot & Ankle, Vol. 14, No. 9Tuberculous synovitis with “rice bodies” presenting as carpal tunnel syndromeThe Journal of Hand Surgery, Vol. 13, No. 4Tuberculosis of the hand and wristThe Journal of Hand Surgery, Vol. 9, No. 3 Vol. 39-B, No. 2 Metrics Downloaded 19 times History Published online 1 May 1957 Published in print 1 May 1957 InformationCopyright © 1957, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download

Tenosynovitis of the forearm

T HIS Iesion, frequently Iooked upon lightly and treated careIessIy, may prove of serious consequence or even become caIamitous in some cases. In my experience it is rather pecuIiar to certain cIasses of workers particuIarIy those requiring powerfu1 grip action of the hand and those whose hands are constantIy subjected to vibration or oft repeated joIts. It is by no means uncommon in such workman. It occurs usuaIIy in the region of the wrist, more frequentIy the dorsum and invoIves the extensor tendons, particuIarIy of the thumb, occasionaIIy occurs upon the paImer aspect and invoIves the flexor tendons. Not infrequentiy it is higher up on the forearm about midway the dorsa1 surface where it is much more apt to be caused by direct bIow such as being struck across the forearm by a faIIing brick or piece of Iumber. AutomobiIe mechanics, so many of whom use pIiers aImost excIusiveIy instead of a wrench, are rather susceptibIe; workers around brick kilns, particuIarIy those who catch brick pitched from ten to tweIve feet above. Here we have not onIy strong grip action but the joIt of stopping the brick, workers around saw miIIs and Iumber yards who aIso use strong grip action and are subject to joIts and vibrations of the hands throughout the day’s work. I have never seen but one case in the Ieft arm and that was a raiIroad engineer in whom the Ieft is the throttIe arm and therefore in much more constant use. IncidentaIIy he was quite obstinate, refused to heed advice or appropriate treatment, deveIoped tuberculosis of many of the extensor tendons and uItimateIy his arm was amputated. At the onset, I am sure, he had onIy a simpIe Iesion and subsequentIy tubercuIosis became superimposed. SimpIe tenosynovitis is characterized by severe pain sharply IocaIized upon motion of the invoIved tendons, quite tender upon paIpation and coarse crepitation. There is but very IittIe if any sweIIing. TubercuIous Iesions have very IittIe pain or tenderness, sweIIing is fusiform in type of the invoIved tendons, noduIar and crepitus is of a much softer type. As the disease progresses sweIIing may become egg shape and rice bodies may become paIpabIe. I have never seen a case of the tubercuIous type who did not give a very