Korean J Radiol.  2013 Jun;14(3):465-469. 10.3348/kjr.2013.14.3.465.

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

Affiliations
  • 1Department of Radiology, Gachon University, Gil Hospital, Incheon 405-760, Korea. youme34@gilhospital.com
  • 2Department of Pathology, Gachon University, Gil Hospital, Incheon 405-760, Korea.
  • 3Department of Orthopedic Surgery, Gachon University, Gil Hospital, Incheon 405-760, Korea.

Abstract

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.

Keyword

Rice bodies; Candida; Arthritis; MRI

MeSH Terms

Aged
Arthritis, Infectious/*microbiology/radiography
Bursa, Synovial/*microbiology/radiography
Candida/isolation & purification
Candidiasis/*microbiology/radiography
Foreign Bodies/*etiology
Humans
Male
Shoulder Joint/*microbiology/radiography

Figure

  • Fig. 1 Imaging and pathologic findings of Candida septic arthritis in right shoulder in a 74-year-old man. A, B. Anteroposterior (A) and axillary (B) radiographs of right shoulder show small bone erosions at glenoid (black arrow) and humeral head (white arrow). Superior migration of humeral head indicates rotator cuff tear. C-E. Axial fat-suppressed proton-density weighted image (C) and coronal T2-weighted image (D) show innumerable rice bodies in right shoulder joint, subacromial-subdeltoid bursa, and subcoracoid bursa. Coronal fat-suppressed T1-weighted image after gadolinium enhancement (E) shows diffuse thickened synovium with enhancement suggestive of synovitis. Bone marrow edema in humeral head and glenoid (C-E) with small subchondral bone erosion at glenoid (arrow in C) suggests osseous involvement of inflammation. F. Resected specimen includes multiple rice bodies of few millimeters in size. G. Resected bursa shows infiltration of chronic inflammatory cells with fibrin deposition and dystrophic calcification (H&E, × 200). H. Rice body is mainly composed of fibrin with some inflammatory cells (H&E, × 100).


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