Chronic bursitis of the shoulder joint with the formation of “rice bodies” in a patient with rheumatoid arthritis (clinical observation)

“Rice bodies” symptom are a secondary clinical manifestation of a number of pathologies involving the synovial tissue. The conditions associated with this phenomenon include rheumatoid arthritis, tuberculosis, juvenile idiopathic arthritis, infectious arthritis, systemic lupus erythematosus, sarcoidosis, and reactions to orthopedic implants. It is possible that other nosological entities may be involved, although no data is currently available. “Rice bodies” present as multiple round-shaped bodies located both intra-articularly and periarticularly in synovial bursae and tendon sheaths. The etiology of this condition remains unknown, reliable statistics on its prevalence are not found in the literature, and its pathogenesis remains controversial. Clinically, the condition may be associated with pain and/or functional limitations, but it can also be asymptomatic and discovered incidentally. The optimal method for diagnosis is magnetic resonance imaging, while the preferred treatment is surgical extraction of the structures along with the adjacent components of hypertrophied synovium, followed by mandatory histopathological examination and conducting differential diagnostics with synovial chondromatosis and villonodular synovitis. These patients require a team-based multidisciplinary approach led by a specialist responsible for treating the underlying disease.

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