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

Do-Young Kim; Jung-Taek Hwang; Sang-Soo Lee; Eun-Min Seo; Yoon-Geol Jo

doi:10.5292/jkbjts.2013.19.2.69

Journal List > J Korean Bone Joint Tumor Soc > v.19(2) > 1052031

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Kim, Hwang, Lee, Seo, and Jo: Surgical Treatment of Multiple Rice Bodies in Chronic Subacromial and Subdeltoid Bursitis: A Case Report

Case Report

J Korean Bone Joint Tumor Soc 2013;19(2):69-73.

Published online: 10 January 2013

DOI: https://doi.org/10.5292/jkbjts.2013.19.2.69

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

Do-Young Kim, Jung-Taek Hwang, Sang-Soo Lee, Eun-Min Seo, Yoon-Geol Jo

Department of Orthopedic Surgery, Hallym University College of Medicine, Chuncheon, Korea

Correspondence to: Jung-Taek Hwang Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, 153, Gyo-dong, Chuncheon 200-704, Korea TEL: +82-33-240-5197 FAX: +82-33-252-0177 E-mail: drakehjt@hanmail.net

Received 20 August 2013 Revised 21 November 2013 Accepted 25 November 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.

Keywords: rice body, subacromial and subdeltoid bursitis, bursectomy

References

1. Chen A, Wong LY, Sheu CY, Chen BF. Distinguishing multiple rice body formation in chronic subacromial-subdeltoid bursitis from synovial chondromatosis. Skeletal Radiol. 2002; 31:119–21.

2. Mutlu H, Silit E, Pekkafali Z, et al. Multiple rice body formation in the subacromial-subdeltoid bursa and knee joint. Skeletal Radiol. 2004; 33:531–3.

3. Kim RS, Lee JY, Jung SR, Lee KY. Tuberculous subdeltoid bursitis with rice bodies. Yonsei Med J. 2002; 43:539–42.

4. Königshausen M, Seybold D, Heyer CM, Muhr G, Gekle C. Tuberculous rice body synovitis of the shoulder joint. Orthopade. 2009; 38:1106–12.

5. Cheung HS, Ryan LM, Kozin F, McCarty DJ. Synovial origins of Rice bodies in joint fluid. Arthritis Rheum. 1980; 23:72–6.

6. Popert AJ, Scott DL, Wainwright AC, Walton KW, Williamson N, Chapman JH. Frequency of occurrence, mode of development, and significance or rice bodies in rheumatoid joints. Ann Rheum Dis. 1982; 41:109–17.

7. Bruggeman NB, Sperling JW, Shives TC. Arthroscopic technique for treatment of synovial chondromatosis of the glenohumeral joint. Arthroscopy. 2005; 21:633.

8. Fowble VA, Levy HJ. Arthroscopic treatment for synovial chondromatosis of the shoulder. Arthroscopy. 2003; 19:E2.

9. Tokis AV, Andrikoula SI, Chouliaras VT, Vasiliadis HS, Georgoulis AD. Diagnosis and arthroscopic treatment of primary synovial chondromatosis of the shoulder. Arthroscopy. 2007; 23:1023. .e1–5.

10. Moosikasuwan JB, Miller TT, Burke BJ. Rotator cuff tears: clinical, radiographic, and US findings. Radiographics. 2005; 25:1591–607.

Figure 1.

Photograph shows preoperative clinical findings.

Figure 2.

(A) Coronal T2 weighted MR image of the left shoulder shows many low signal intensity rice bodies. (B) Axial T2 weighted MR image shows multiple rice bodies with low signal intensity.

Figure 3.

A postoperative photo demonstrates removed multiple rice bodies.

Figure 4.

A postoperative photo shows resected subacromial and deltoid bursa.

Figure 5.

Microscopic finding shows a free rice body consists of a collagenous core with interspersed chronic inflammatory cells surrounded by a thin fibrin layer in hematoxylin and eosin stained specimen. There is no evidence of unmineralized metaplastic cartilage. (A) ×20. (B) ×400.

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