J Rheum Dis.  2016 Oct;23(5):316-320. 10.4078/jrd.2016.23.5.316.

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

• Chung WY
• Song JS
• Oh HE
• Park HJ

• KMID: 2356487
• DOI: http://doi.org/10.4078/jrd.2016.23.5.316

Abstract

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.

Keyword

Rice body; Knee; Rheumatoid arthritis; Tuberculosis

MeSH Terms

Arthritis
Arthritis, Rheumatoid*
Bursitis
Fibrin
Humans
Inflammation
Knee Joint*
Knee*
Synovial Membrane
Tuberculosis*
Fibrin

Figure

• 

  Figure 1. Magnetic resonance images of the right knee. (A) T1-weighted image (T1WI) and (B∼ D) T2-weighted images (T2WI) showed a large amount of joint effusion with numerous low-signal foci against a background of fluid signal intensity on T2WI. Anterior and posterior cruciate ligaments and collateral ligaments were intact.

• 

  Figure 2. Gross morphology of rice bodies in the washing synovial fluid and arthroscopic findings. (A) Many white amorphous materials were found in the washing synovial fluid collected through arthroscopic irrigation. Arthroscopic findings were consistent with rice bodies in the suprapatellar space (B) and revealed a normal synovium (C).

• 

  Figure 3. Pathology of rice body and synovium. (A) Microscopic examination (H&E, x40) revealed multiple nodular fi-brocartilaginous tissues consistent with rice bodies. (B) The synovium of the knee joint (H&E, x100) showed a histologically clean synovial surface.

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