Rice Body Formation Research Articles

Rice Grain Bursitis: Rare Manifestation of TB in Wrist Joint

This case report highlights about rice grain bursitis- rare manfiestation of TB in wrist joint. Subacromial-subdeltoid bursitis of a shoulder with rice bodies is relatively uncommon. The understanding of the pathogenesis of rice body formation is yet approximate only but some clinical conditions like rheumatoid arthritis, tuberculous arthritis, seronegative inflammatory arthritis, juvenile rheumatoid arthritis and osteoarthritis are related to it. A 30yr Male patient presented with complaints of pain and swelling in the wrist joint , which was insidious in onset. It was associated with evening rise in temperature. Frequenetly erosion of the underlying bone, secondary osteomyelitis and median nerve encasement are present.

Wrist Extensor Tenosynovitides: A Case Report

Background: Rice bodies can be found in rheumatic diseases, infectious diseases, and osteoarthritic joints. Rice bodies' most common locations include the subacromial bursa of the shoulder and the knee, while rice body synovitis of the wrist extensor tendons is uncommon. We have presented the case of tuberculous tenosynovitis with rice body formation in the extensor tendon sheaths of the hand and wrist.
 Case Report: A 51-year-old man presented with swelling and mild pain in the dorsal side of left wrist, hand, and proximal phalanx of the second finger. He stated a history of traumatic injury to the proximal phalanx of the index finger. Radiographs showed a softtissue mass shadow, and magnetic resonance imaging (MRI) showed edema and soft tissue swelling around extensor tendons extending into the distal forearm and ulnar side of the second finger in favor of tenosynovitis. Laboratory test results were normal. The patient had a negative Mantoux test result and no history of mycobacterial exposure. Surgical exploration of the lesion revealed rice bodies in the synovial sheath of extensor tendons in the wrist, extending distally to the dorsal aspect of the hand, especially the radial side. Removal of the rice bodies and complete excision of the sheath and tenosynovectomy was performed.
 Conclusion: As in our case, even in the absence of past tuberculosis (TB) infection or exposure, Mycobacterium TB (MTB) should be considered in the differential diagnosis of long-standing extensor tenosynovitis in the hand and wrist.

Idiopathic Tenosynovitis with Rice Bodies: Clinical Case Report

Introduction: Tenosynovitis is the main cause of pain in the upper limbs; it can be originated from infectious and non-infectious causes. 50% of reported cases are tuberculous tenosynovitis. When the rice body formation pathogenesis is uncertain after performing all extension studies, it is called idiopathic tenosynovitis. Clinical Case: A 79- year-old male patient with a pathological history of chronic ischemic heart disease treated with cardiac catheterization with stent placement comes to the Plastic Surgery Office due to the presence of multiple masses on the back of the right hand in zone V, VI and VII with 3 years of evolution, without significant accompanying symptoms. Physical examination revealed the presence of multiple non-painful mobile masses of approximately 4x5cm in the extensor zone V, VI and VII of the right hand. In the surgical exploration for biopsy, within the macroscopic characteristics, multiple converging and interconnected masses were found with granular content infiltrating sheath and tendon itself (II, III, IV and V fingers of the right hand). Posterior capsule of masses is in contact with intrinsic and interosseous muscles of the right hand with the appearance of rice bodies. At the moment, the patient shows a favorable evolution and continues in periodic controls. Conclusions: In this case, having no underlying diseases related to this pathology and having ruled out among the differential diagnoses, it was determined that the occurrence of rice body masses in an infiltrative manner in the tendons is of an idiopathic origin, so our patient will remain on long-term follow-up, but so far with favorable evolution.

Massive “risotto bursitis” of the great trochanter bursa after proximal femoral varus osteotomy with 5,0 LCP- a case report

The “risotto phenomenon” is a rare pathologic finding, mostly seen as a nonspecific response to chronic inflammation around the shoulder joint- subacromial and subdeltoid bursitis, rheumatoid arthritis, sero-negative inflammatory arthritis, septic arthritis and tuberculous arthritis. A few scientific reports associate rice body formation with the use of different type of osteosynthesis, bony anchors and bioabsorbable sutures. They are usually an incidental asymptomatic finding, requiring no specific treatment, but could be symptomatic demanding surgical excision. We present the clinical case of a 17-year- old female patient with a “risotto bursitis” of the great trochanter bursa, documented during planned surgical removal of a locking compression plate after proximal femoral varus osteotomy for bilateral developmental dysplasia of the hip treatment.

Unusual presentation of rice body formation in a patient without tuberculosis or rheumatic disease: report of a rare case and literature review

Tabrizi, Ali MDa; Mohammadi, Sedrab; Ghasemi-Rad, Mohammad MDc; Dindarian, Sinab Author Information

Tibialis Posterior Tenosinovitis with non tubercular rice body formation due to retained thorn – A Rare Case Report

Introduction: Tibialis posterior tendon dysfunction presents one of the most challenging problems that a foot and ankle specialist faces. This case report represents a very unusual presentation of retained thorn in the tendon of tibialis posterior with its management. Case presentation: A sixteen years old boy presented with H/O thorn prick injury to left ankle joint on medial side 3 months back while playing. He complain of pain and swelling on medial side of left ankle joint. He was treated at local hospital but pain and swelling partially subsided for initial 4 weeks. Then gradually pain and swelling increases over a period of 3 months. Patient was investigated (X-rays, CT Scan, MRI left ankle joint) and diagnosed as Tibialis Posterior Tenosinovitis following retained 1.5cm long thorn piercing the tendon. Surgically retained thorn was removed. Rice bodies removed from the tendon sheath found to be non tuberculous. Discussion: Tibialis posterior tenosinovitis along with rice body formation due to retained thorn following thorn prick injury is a very rare case. Mechanical irritation leading to chronic sinovitis due to thorn was responsible for the tibialis posterior tenosinovitis and non tuberculous rice body formation. In this case, surgically removing the thorn made patient symptom free and no recurrence till 5 years followup. Conclusion: Posterior tibial tendon tenosynovitis is now a recognized entity no longer confused with chronic ankle sprain or other foot / ankle disorders. Careful examination and investigation is necessary to differentiate these condition and provide appropriate treatment Keywords: Tibialis Posterior, tenosinovitis, rice body

Rice body formation in the knee joint: a case report and review of literature

Rice body formation in the knee joint: a case report and review of literature

Rice-body formation without rheumatic disease or tuberculosis in a “sausage” ring finger

Rice bodies are very unusual lesions, generally encountered in chronic synovitis due to rheumatoid diseases or tuberculosis. A 31-year-old right-handed man presented with a 15-year history of progressively growing “sausage-like” swelling of the 4th finger and palm of his right hand. There was an immovable, painless mass with restriction of the finger's ROM without local or general associated signs. Imaging showed a large non-aggressive mass within the tendon sheath. Complete excision of the mass was performed. Histopathological examination showed synovial villi with rice bodies and central necrosis suggestive of tuberculous synovitis or rheumatoid arthritis (RA). Tests for mycobacterial infections were all negative and there was no argument in favor of a rheumatoid pathology. There is no established standard treatment in a case like ours, which has no origin in tuberculosis or RA. Prolonged follow-up will be needed to confirm absence of recurrence after complete excision.

Rice body formation without rheumatic disease or tuberculosis infection in a sausage ring finger – a case report

Subcutaneous masses in the finger gather numerous lesions, among which tumors, inflammation-induced lesions, and post-traumatic lesions. Rice bodies are very unfrequent lesions, encountered in rheumatoid or tuberculous chronic synovitis. We present the case of a young patient with no history of tuberculosis infection or rheumatoid pathology who required surgical treatment for a rice body formation localized on the palmar side of the fourth left finger. A 31-year old, right dominant hand man presented with a 15 years history of progressively growing “sausage-like swelling” of the finger. There was an inamovible, painless mass with restriction of the DIP and PIP joints range of motion, without skin lesion, redness or stiffness. Imaging showed a large non-agressive mass within the tendon sheath. We realized a complete excision of the mass. Histopathological examination showed synovial villus with body rice shape and central necrosis evoking tuberculous synovitis or reumatoid arthritis. However, there was no argument for mycobacterial infection nor rheumatoid pathology. Rice bodies mostly evoke chronic synovitis or arthritis in northern countries, but may also be found in infectious diseases such as mycobacterial infections, related to chronic bursitis. No physiopathological mechanism has been formally identified (microinfarctions after intra-articular synovial inflammation and ischemia + de novo formation and progressive enlargement by fibrin + alteration in fluid viscosity and fibrinogen content of the synovial fluid). Different locations of rice bodies have been documented such as shoulder, knee, extensor tendon in the hand, wrist and carpal tunnel and flexor tendon sheath, but at the knowledge of the authors, this is the first reported case of digit flexor sheath rice body formation not related to inflammatory disease such as mycobacteria infection or rheumatoid arthritis. Differential diagnosis include synovial chondromatosis, pigmented villonodular synovitis, gout, sarcoidosis, systemic lupus erythematosus, chronic fungal infection and atypical mycobacterial infection, but the absence of suggestive complications, negative bacterial and fungal cultures, and laboratory test results, allowed us to assume the absence of classic etiology. In a case like ours, even less described than tuberculosis or arthritis, there is no established treatment standard. Despite the absence of associated systemic therapy, radical excision of the mass should provide definitive treatment. Therefore, prolonged observation will be necessary to confirm absence of recurrence with radical excision. Rice body formation should be better known as a muskulosqueletal form of mycobacterial infection or rheumatoid affection either by radiologists, surgeons and pathologists to provide optimal care for patients.

Rice body formation in a case of subdeltoid bursa tuberculosis: An uncommon presentation

Rice bodies looking like swelling on specific magnetic resonance sequences are an unusual presentation of subdeltoid tuberculous inflammatory involvement. Rice bodies represent the infarcted or sloughed off synovium due to the inflammatory process. We present a case of a 21-year-old male patient who complained of a soft-tissue swelling around the right shoulder presumed to be a lipoma. The aim of presenting this case is to expand the differential diagnosis of soft-tissue swelling around the shoulder whenever such a condition is encountered.

A Case Report of Rice Body Formation in Tenosynovitis of Extensor Tendons of the Wrist.

Rice bodies were first described in association with tuberculous arthritis in 1895 but now seen most commonly in patients with rheumatoid arthritis(R.A).Rice bodies named after their macroscopic likeness to polished grains of rice are common finding in inflammatory arthropathies like R.A,S.L.E and seronegative arthritides.These are fibrous bodies which may create diagnostic confusion when the patient has no underlying inflammatory disease.We report such a case with a large soft tissue swelling over dorsum of wrist whose surgical exploration revealed rice bodies in the extensor tendons synovial sheath.The patient regained full painless range of motion post-operatively.

Multiple Rice Body Formation in Subacromial and Subdeltoid Bursal Spaces

We encountered a rare condition of rice body in subacromial and subdeltoid spaces in a patient with unremarkable medical history. Although it is uncommon, there have been continued reports on its formation in certain type of infective and inflammatory arthritis. However, except for a traumatic event, evaluation yielded no known and conceivable cause for his chronic inflammatory bursitis. Relatively typical findings for rice body on magnetic resonance imaging have been described, and in our case the imaging prompted us to schedule early removal, which is generally accepted as the management of choice to prevent further progression of symptoms. The symptoms of the shoulder showed significant improvement, and a close follow-up schedule has been recommended for observation of recurrence and development of any foreseeable underlying cause.

Tuberculosis of wrist joint with rice body formation: A case report

Tuberculosis of the wrist and hand is a rare infectious disease, Because of the rarity of these cases, early diagnosis is often difficult. We report a case of 55-year-old male agriculture worker came to our OPD due to a palpable tumor mass over his right wrist which had progressively enlarged since 2 years ago. He had mild pain and swelling on the volar aspect of the wrist and radial side of hand, he also complains of pain and inability to do movements in the right thumb. The patient had no history of systemic disease, or tuberculosis. Radiography showed a soft-tissue mass shadow, with destruction of wrist joint and osteoporosis, and magnetic resonance imaging was not done because of patient non-affordability with financial constraints. Laboratory test results were normal, except for an elevated erythrocyte sedimentation rate. The patient had an ambiguous Mantoux test result but no history of mycobacterial exposure. Investigations for rheumatic disease were negative. Surgical exploration of the lesion revealed rice bodies in the common flexor tendon synovial sheath, extending up to meta-carpo phalangeal joint of thumb. Removal of the rice bodies and thorough excision of the sheath was performed and Joshis external stabilization system (JESS) was applied. The patient regained a painless restricted range of motion in about 6 months. One-year follow-up revealed no underlying disorder.

Giant Bursitis of Wrist and Multiple Tenosynovitis of Hand with Rice Body Formation: Unusual Case of an Atypical Mycobacteria Infection

We report an unusual manifestation of nontuberculous mycobacterial infection characterized by a giant bursitis on wrist and multiple tenosynovitis with many rice bodies formations. The clinical and radiological examinations are neither rather sensitive nor rather specific. The nuclear imagery of rice bodies formations provides elements of guidance. Cause of absence of the germ isolation, diagnosis was retained on probability items based on a suspicion of arguments beam: clinical, biological, bacteriological and histological. The patient was treated with medical and surgical procedure and provided a satisfactory evolution. At follow-up of 15 months, there were no clinical signs of local recurrence. Through a literature review, the problem of diagnosis of certainty will be discussed.

Rice Body Tenosynovitis without Tuberculosis Infection after Multiple Acupuncture Procedures in a Hand.

Rice Body Tenosynovitis without Tuberculosis Infection after Multiple Acupuncture Procedures in a Hand.

The Risotto sign – a severe inflammatory bursitis with rice body formation, complicating a rotator cuff repair with a bioabsorbable suture anchor

LessonThere is an association between inflammatory bursitis with rice body formation and use of bioabsorbable suture anchors.

Tenosynovitis with rice body formation presenting as a cutaneous abscess

A 62-year-old woman with a past medical history of rheumatoid arthritis was referred to the Department of Dermatology because of an enlarging cutaneous lesion on the right thumb which resembled a soft tissue infection. She had received antibiotics without significant improvement. Clinical examination revealed an erythematous nodule involving almost the whole surface of the distal phalanx with spontaneous drainage of countless of small yellowish ovoid granules. Histopathologic study of these structures showed an inner core of amorphous acidophilic material with some interspersed chronic inflammatory cells and a surrounding thin fibrin layer. Special stains and cultures were negative for parasites, bacterium and mycobacterium. Magnetic resonance imaging (MRI) revealed distension of the first and fifth finger flexor sheaths and common finger flexor sheath. These areas were filled by fluid and multiple small nodular lesions. A diagnosis of non-infectious rice body tenosynovitis was rendered and surgical removal was performed. Total recovery was observed with no evidence of recurrence after 6 months of follow-up. To our knowledge, this is the first report of rice body tenosynovitis presenting as a pseudoinflammatory cutaneous lesion with evolution to a cutaneous fistula with drainage of rice grain-like structures. The description of this impressive and peculiar clinical and histopathologic picture is important to further recognize similar cases.

CandidaSeptic Arthritis with Rice Body Formation: A Case Report and Review of Literature

Rice body formation in a joint or bursa is a rare condition, and is usually associated with rheumatoid arthritis or tuberculous arthritis. Here we describe a case of multiple rice body formation in a shoulder joint and in adjacent bursae, which was confirmed to be due to septic arthritis by Candida species. To the best of our knowledge, rice body formation in Candida septic arthritis in an immune-competent patient has not been previously reported.

Rice body formation characterized by the chronic non-specific tenosynovitis in the tibialis anterior tendon

In this case report a 38-year-old woman who presented with swelling and pain on her right ankle for two years is presented. Physical and radiological examinations revealed a soft, lobulated and fixed mass in the ankle. During surgical resection shiny, whitish bodies were removed from the tendon sheath of tibialis anterior and synovectomy was performed. Histopathological diagnosis was rice body formation and syovitis. There was no recurrence at the 5th year follow-up. Magnetic resonance imaging was effective in the diagnosis of this rare case of extra articular rice body formation presenting with tenosynovitis and full recovery was achieved with surgical treatment.

関節リウマチ患者の手背部腫瘤内に米粒体形成を認めた 1 例

関節リウマチ患者の手背部腫瘤内に米粒体形成を認めた 1 例