A Case of Idiopathic Massive Rice Bodies in the Knee Joint without Rheumatoid Arthritis or Tuberculosis and a Literature Review

Rice bodies are materials with an amorphous nucleus and a fibrin layer found floating in the synovial space and bursa. These bodies have often been detected in patients with rheumatoid arthritis, tuberculous arthritis, and bursitis. Although the etiology and pathogenesis of rice bodies are not yet fully understood, it has been hypothesized that they might be caused by chronic inflammation originating from the synovium. However, we report on a case of idiopathic massive rice bodies in the knee joint without evidence of inflammatory articular disease or infection including rheumatoid arthritis, seronegative spondyloarthritides, tuberculosis, or bacterial or fungal infection.

Surgical Treatment of Multiple Rice Bodies in Chronic Subacromial and Subdeltoid Bursitis: A Case Report / 대한골관절종양학회지

Multiple rice body formation is a complication of chronic bursitis frequently associated with seronegative rheumatoid arthritis or tuberculosis. It resembles synovial chondromatosis on imaging and clinically. We report on a pathologically diagnosed multiple rice body formation in subacromial and subdeltoid bursitis in a 44-year-old man who was treated by surgical removal and bursectomy. At 16 months after the removal, range of motion of affected shoulder was normal. No evidence of recurrence of rice body in plain X-ray and ultrasonography. Multiple rice body formed in chronic subacromial and subdeltoid bursitis could be treated with surgical removal and bursectomy successfully.

'Rice Body' Containing Cystic Tumor Occurred at the Volar Aspect of the Finger / 대한피부과학회지

'Rice body' is a soft tissue nodule resembling shiny white rice-bean, which is occasionally observed at the juxta-articular area among patients with rheumatic arthritis and tuberculosis arthritis. A 45-year-old man was presented with tender cystic tumor on the volar aspect of the left third finger, which was noted 5 months prior to the visit. When performing a biopsy, numerous, whitish granular, 5~10 mm in size, and ovoid substances were observed, and found to be the major component of the cystic tumor. Histologically, the granules were consistent with the so-called 'rice bodies' (granules of inner acidophilic material surrounded by fibrin/collagen). With these findings, we report a case of rice body-containing cystic tumor clinically reminiscent of other cystic lesions, which can be seen on the finger around the joint structure.

A Case of Multiple Rice Bodies by the Nonspecific Synovitis in the Knee Joint

Multiple rice bodies are commonly observed in various rheumatologic disorders and tuberculous arthritis, but rice bodies are rarely observed in nonspecific synovitis without any underlying disease. We performed arthroscopic rice body removal and synovectomy for nonspecific synovitis with multiple rice bodies in a 31-year-old male patient, and the results were satisfactory. No evidence of underlying disease, including rheumatoid arthritis or tuberculous arthritis, was observed during 2 years on the follow-up evaluations after the arthroscopic procedure. There have been very few confirmed rice bodies cases without underlying disease, so making a careful differential diagnosis to rule out rheumatologic and infectious disorders is required to avoid possible aggravation of disease, which may result in persistent articular cartilage destruction.

Histology of two rice bodies isolated from the stifle of an adult draught horse stallion

In the human and equine species, different kinds of free floating intra-articular particles are related to certain disorders. Osteochondral fragments formed during osteochondrosis dissecans are the most common finding in the equine species, whereas in humans rice bodies due to rheumatoid arthritis are more frequent. Herein we report a third type of floating body inside the stifle of an adult draught horse stallion, in macroscopic appearance similar to articular rice bodies known in humans. As revealed by histologic examination, the two particles consist of polypoid degenerated structures derived from synovial villi. Their formation was probably induced by ischemia.

Massive Subacromial Bursitis with Rice Bodies in Rheumatoid Arthritis / 대한류마티스학회지

Rice bodies are numerous small fibrinous, cartilaginous-like materials which were first described in tuberculous joints. Rice bodies are common findings in joints afflicted with rheumatoid arthritis or other seronegative arthropathy. But less commonly, those can be seen in periarticular bursae or at the sites of tendon or ligament insertion. Rice bodies, thought to be a nonspecific response to synovial inflammation, probably evolve from ischemia in a proliferative synovium. Some of these bodies contain a core of collagen with a mantle of fibrin, others contain only fibrin. Subacromial bursa are sometimes involved in the patients with rheumatoid arthritis and can reach impressive dimensions before becoming clinically detectable because significant constrain is lacking. Subacromial arthrography or magnetic resonance imaging accurately delineated the existence of cartilaginous loose bodies before surgical exision. We experienced a man with rheumatoid arthritis who had massive subacromial bursitis with rice bodies. His shoulder had been swollen since 5 years ago. He felt no pain and had only mild limitation of motion. Subacromial arthrography or magnetic resonance imaging of right shoulder showed multiple rice bodies in enlarged subacromial bursa. Operation finding showed a large encapsulated mass in the subacromial bursa, and hundreds of fibrinous rice bodies were revealed, which were resected. We report this patient with a review of literatures.

Extraosseous Tuberculosis of the Extremities / 대한정형외과학회잡지

Extraosseous tuberculosis of the extremities is relatively rare even in the wide spread incidence of bone and joint tuberculosis. And few reports about extraosseous tuberculosis of the extremities have been published in the literatures. Eight cases of the extraosseous tuberculosis of the extremities were experienced at the Department of Orthopaedic Surgery, National Medical Center, from 1975 to Sep. 1979. Five out of 8 extraosseous tuberculosis were tenosynovitis and the others were bursitis in location. All cases were surgically excised and combined with antituberculous chemotherapy, and primarily cured.