Presentation
Left shoulder pain and middle finger small cutaneous nodule. Rest of history is withheld.
Patient Data
Synovial thickening and enhancement of the subacromial/subdeltoid bursa associated with multiple rice bodies which tend to be amalgamated forming mas like lesion anteriorly showing marginal synovial enhancement. Arthropathic changes of the glenohumeral and acromioclavicular joints with joint space narrowing and erosive changes.
Arthropathic changes including erosive changes of the acromioclavicular joint. The aforementioned rice bodies are radiolucent.
Middle finger distal phalangeal subcutaneous small soft tissue nodule, likely representing rheumatoid nodule.
Arthropathic changes of the radiocarpal joint are evident in the narrowing of their joint spaces and subchondral pseudocystic changes.
Case Discussion
Multiple rice bodies in joints or bursae may be the presenting sign of a more extensive underlying rheumatic condition. This case was a known rheumatoid patient. The radiological features are typical for rheumatoid arthritis with rice bodies in the subacromial-subdeltoid bursa, an aggregate-forming mass-like lesion anteriorly, arthropathic changes of the radiocarpal joint and a small subcutaneous rheumatoid nodule seen at the ventral aspect of the distal phalanx of the middle finger, confirmed clinically.
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