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Rheumatology 2007 46(1):64; doi:10.1093/rheumatology/kei121
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Imaging of rice bodies in a non-rheumatoid shoulder

Robin M. Seagger and Simon J. Gregg-Smith

The Royal United Hospital, Orthopaedic Department, Bath, UK

Correspondence to: R. M. Seagger. E-mail: robin.seagger{at}gmail.com

A previously well 36-yr-old woman presented with an 11-week history of pain and swelling of her right shoulder following minor trauma. Examination showed a significant, fluctuant, subdeltoid swelling with anterolateral subacromial tenderness. She had a full range of movement with positive impingement signs.

MRI and ultrasound scans were organized. The scans showed an abnormality deep to the deltoid suggestive of a distended subdeltoid bursa with possible rice bodies. The bursa was aspirated, yielding clear, straw-coloured fluid. The aspirate was sterile and contained only inflammatory cells and fibrin.

She was admitted for arthroscopy to obtain a tissue diagnosis. At surgery, large numbers of small granular rice bodies were identified and flushed from the bursa. Synovial biopsies were also sent for histology.

The patient made a rapid recovery with resolution of the pain and swelling. Histology of the granules revealed fibrin and inflammatory cells. Synovial biopsies showed chronic inflam matory changes only.

Rice bodies have a well-documented association with rheumatoid arthritis and therefore the patient was screened with routine serology. All blood tests were within normal limits and the patient has had no further presentations with recurrence or other arthropathies after 24 months.


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