Rice bodies (musculoskeletal)
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Rice bodies are multiple small loose intra-articular bodies that macroscopically resemble polished grains of white rice. They are located in the synovial fluid, bursae or tendon sheaths 4.
Rice bodies can range from asymptomatic to causing joint pain, effusion and occasionally mechanical symptoms such as locking.
The pathogenesis of these loose bodies has been debated and is probably multifactorial. Proposed theories suggest that it may be due to shedding of infarcted synovium, a nidus of cellular debris 7 or they may develop independently subsequently becoming encased by fibrin 1,2 with different levels of organization.
They are most commonly seen in rheumatoid arthritis 4 but may also be seen in 1-3:
- chronic synovitis
- chronic bursitis
- T1: iso- to hypointense
- T2: hypointense
- T1 C+ (Gd): non-enhancing
If tightly packed, they may be hard to differentiate especially if isointense to joint effusion.
- high T2 signal (when non-mineralized)
- 1. O'Brien WT. Top 3 Differentials in Radiology. Thieme. (2011) ISBN:B005TJOKB2. Read it at Google Books - Find it at Amazon
- 2. Chau CL, Griffith JF, Chan PT et-al. Rice-body formation in atypical mycobacterial tenosynovitis and bursitis: findings on sonography and MR imaging. AJR Am J Roentgenol. 2003;180 (5): 1455-9. doi:10.2214/ajr.180.5.1801455 - Pubmed citation
- 3. C Chung, B D Coley, L C Martin. Rice bodies in juvenile rheumatoid arthritis. (2013) AJR. American journal of roentgenology. 170 (3): 698-700. doi:10.2214/ajr.170.3.9490956 - Pubmed
- 4. William Palmer, Laura Bancroft, Fiona Bonar, Jung-Ah Choi, Anne Cotten, James F. Griffith, Philip Robinson, Christian W.A. Pfirrmann. Glossary of terms for musculoskeletal radiology. (2020) Skeletal Radiology. doi:10.1007/s00256-020-03465-1 - Pubmed