6
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      A Case of Rice Body Synovitis of the Knee Joint

      case-report
      , Master 1 , , PhD 2 , , Master 1 , , Master 1 , , Master 1 , , PhD 2 , , , PhD 2 , , , PhD 3
      Orthopaedic Surgery
      John Wiley & Sons Australia, Ltd
      Knee joint, MRI, Synovitis

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Rice body synovitis (RBS) is a rare disease. It is prone to be developed due to rheumatoid disorder or tuberculosis infection. Additional infectious arthritis (non‐tuberculous mycobacterial infection and fungal infection), juvenile arthritis, the onset of adult Still's disease, systemic lupus erythematosus (SLE), seronegative arthritis, and non‐specific arthritis. The clinical imaging, histopathological features, and surgical treatment process of a patient were documented combined with literature. Furthermore, differentiation was performed with additional synovitis diseases so that the cognition of synovitis could be enhanced for clinical reference.

          Case Presentation

          The present study reported a 50‐year‐old female patient who suffered from intermittent left knee pain with limited movement for 9  years. The conditions were aggravated after long‐term standing or walking and remitted after taking a rest, accompanied by noose and jamming. The specialist range of motion (ROM) examinations of the left knee revealed: 30° ‐ 0° ‐ 110° and left McMurray sign (+). Plain MRI scanning revealed that in the left knee cavity and the popliteal fossa area, a large number of low signals on free rice‐like bodies were visible inside and the lower femur and the upper tibia exhibited abnormally high signals of patchy lipography. Surgical exploration revealed numerous rice‐like free bodies in the suprapatellar bursa, the intercondylar fossa, and the posterior articular capsule. The patient presently has resolution of symptoms after surgical treatment.

          Conclusions

          The RBS of the knee joint is very rare in the clinic. As MRI examination can provide valuable information, clinicians should actively perform MRI examination. Once the disease is diagnosed by examination, surgery is the optimal treatment.

          Abstract

          The clinical, imaging, histopathological features, and surgical treatment process of the patient were documented combined with literature. As MRI examination can provide valuable information, clinicians should actively perform MRI. Once the disease is diagnosed by examination, surgery is the optimal treatment.

          Related collections

          Most cited references17

          • Record: found
          • Abstract: found
          • Article: not found

          Synovial osteochondromatosis of the elbow.

          We present 12 patients with synovial osteochondromatosis of the elbow treated by synovectomy. Histological review showed that seven cases were primary and five secondary osteochondromatosis. The patients with primary disease had a mean improvement in the flexion arc from a preoperative value of 40 degrees to 123 degrees to 5 degrees to 128 degrees when reviewed at a mean of nine years after operation. The secondary group had a mean improvement in the flexion arc from a preoperative value of 21 degrees to 98 degrees to 4 degrees to 131 degrees at a mean of 6.8 years after operation. There was recurrence in two of seven patients in the primary group and three of five in the secondary group. Osteoarthritis developed in six elbows in the primary and in three in the secondary group. Osteoarthritis secondary to synovial osteochondromatosis is progressive. In the established condition, the distinction between primary and secondary disease may be of greater histological than clinical relevance.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Rice body formation without rheumatic disease or tuberculosis infection: a case report and literature review.

            Rice body formation is an uncommon inflammatory disorder associated with systemic disorders such as rheumatoid arthritis and tuberculosis infection. The pathophysiology of rice bodies is poorly understood. We describe a case of rice body formation in a 51-year-old male who presented with pain and swelling of the left wrist. The patient had no previous history of rheumatic disease, joint trauma, or infectious disease. He underwent a radical tenosynovectomy and had immediate improvement of symptoms. Despite extensive evaluation, the etiology of the rice bodies could not be identified. An increasing number of case reports have described rice body formation without a known cause suggesting an alternative, unidentified method of pathogenesis. We describe a unique case of rice body formation and a review of the literature with emphasis on theories of pathogenesis, diagnostic methods, and treatment.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Frequency of occurrence, mode of development, and significance or rice bodies in rheumatoid joints.

              The incidence of rice bodies (RB) in synovial effusions has been studied in 36 patients with rheumatoid arthritis (RA) and in 12 patients with seronegative inflammatory arthritis (7 cases of Still's disease, 3 of psoriatic arthritis, and 2 of ankylosing spondylitis). In the RA group 50 joints were aspirated before and after saline lavage with a specially designed wide-bore needle. RB were found in 72% overall of the joints studied in this group, 14% on initial simple aspiration and an additional 58% after lavage. In contrast no rice bodies were found in 31 aspirations with lavage by an identical technique in the 12 patients with seronegative synovitis. The RB in RA synovitis occurred both early and late in the course of the disease and were not related to the severity of clinical or radiological changes. However, removal of rice bodies was accompanied by clinical improvement and reduction of synovitis. Macroscopically RB varied in shape and size, some being so large as to preclude effective removal by needles of the gauge customarily employed for joint aspirations. Microscopically the majority of RB were composed of coarsely reticular material reacting immunologically with antifibrinogen and antifibronectin and containing mononuclear cells. Some showed vacuolation suggestive of fibrinolysis, but many showed organisation like that seen in established connective tissues, with the formation of mature collagen, reticulin, and elastin. These findings are discussed in relation to the origin, development, and significance of rice bodies in rheumatoid synovitis.
                Bookmark

                Author and article information

                Contributors
                zhaoxia3032@163.com
                ytb8912@hotmail.com
                Journal
                Orthop Surg
                Orthop Surg
                10.1111/(ISSN)1757-7861
                OS
                Orthopaedic Surgery
                John Wiley & Sons Australia, Ltd (Melbourne )
                1757-7853
                1757-7861
                16 March 2022
                March 2022
                : 14
                : 3 ( doiID: 10.1111/os.v14.3 )
                : 628-632
                Affiliations
                [ 1 ] Qingdao University Qingdao China
                [ 2 ] Orthopedics Department of the Affiliated Hospital of Qingdao University Qingdao China
                [ 3 ] Trauma Emergency Center of the Third Affiliated Hospital of Hebei Medical University Shijiazhuang China
                Author notes
                [*] [* ] Address for correspondence Yu Tengbo, PhD and Zhao Xia, PhD, 16 Jiangsu Road, Shinan District, Qingdao, Shandong province, China. Tel: 18661808912; Email: ytb8912@ 123456hotmail.com (Y. T.); and Tel: 18661803032; Email: zhaoxia3032@ 123456163.com (Z. Y.)

                Author information
                https://orcid.org/0000-0003-3239-2048
                Article
                OS13195
                10.1111/os.13195
                8926980
                35297195
                2da10c1f-b5de-404e-8c17-5ec6c1ba7dcc
                © 2022 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 November 2021
                : 23 June 2021
                : 22 November 2021
                Page count
                Figures: 5, Tables: 0, Pages: 5, Words: 2830
                Categories
                Case Report
                Case Reports
                Custom metadata
                2.0
                March 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.2 mode:remove_FC converted:17.03.2022

                knee joint,mri,synovitis
                knee joint, mri, synovitis

                Comments

                Comment on this article