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Multiple Rice Body Formation in Subacromial and Subdeltoid Bursal Spaces 원문보기

Clinics in shoulder and elbow, v.19 no.2, 2016년, pp.96 - 100  

Shin, John Junghun (Department of Orthopedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ,  Lee, Jun-Pyo (Department of Orthopedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ,  Kim, Doo-Sup (Department of Orthopedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine)

Abstract AI-Helper 아이콘AI-Helper

We encountered a rare condition of rice body in subacromial and subdeltoid spaces in a patient with unremarkable medical history. Although it is uncommon, there have been continued reports on its formation in certain type of infective and inflammatory arthritis. However, except for a traumatic event...

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제안 방법

  • In addition inflammatory markers were reduced to and stayed within normal range during the follow-ups. Immediately after surgery the patient was referred to a rheumatologist for evaluation of medical diseases including rheumatoid arthritis, which may have caused the current inflammatory condition.
  • Cultures including bacteria, tuberculosis, and fungal infection for bursal tissue and drained serosanguinous fluid showed a negative result. Serologic tests were performed postoperatively for rheumatoid factor and anticyclic citrullinated peptide, and they yielded a negative finding. Antinuclear antibody was positive in a 1:40 dilution.
  • Plain radiographic finding was insignificant. To rule out rerupture of the repaired tendon and to assess the palpable mass, MRI was ordered. On MRI, innumerable delineated small nodules were observed in markedly distended subacromial and subdeltoid bursa with a large amount of bursal fluid.

대상 데이터

  • A 70-year-old male patient visited our outpatient clinic after suffering pain on his right shoulder for two months. He complained of pain on movement and a palpable mass in his shoulder.
  • 1,6,8,9) In this case report, we encountered a patient with pain and a mass in his right shoulder who had no previous or current inflammatory or infective condition. The patient, a 70-year-old male who had previously undergone arthroscopic rotator cuff repair in his right shoulder, had developed a cystic like mass after a trauma to the shoulder several months before visiting our clinic, and despite having no underlying cause, rice body was confirmed by magnetic resonance imaging (MRI) and surgical drainage. The patient was explained about the study and agreed to provide informed consent.
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참고문헌 (10)

  1. Mutlu H, Silit E, Pekkafali Z, et al. Multiple rice body formation in the subacromial-subdeltoid bursa and knee joint. Skeletal Radiol. 2004;33(9):531-3. 

  2. Sugano I, Nagao T, Tajima Y, et al. Variation among giant rice bodies: report of four cases and their clinicopathological features. Skeletal Radiol. 2000;29(9):525-9. 

  3. Popert AJ, Scott DL, Wainwright AC, Walton KW, Williamson N, Chapman JH. Frequency of occurrence, mode of development, and significance or rice bodies in rheumatoid joints. Ann Rheum Dis. 1982;41(2):109-17. 

  4. Subramaniam R, Tan JW, Chau CY, Lee KT. Subacromial bursitis with giant rice bodies as initial presentation of rheumatoid arthritis. J Clin Rheumatol. 2012;18(7):352-5. 

  5. Stein AJ, Case JL, Berman J, Levy H. Case report 770. Chronic subacromial bursitis with massive formation of rice bodies. Skeletal Radiol. 1993;22(1):71-3. 

  6. Tan CH, Rai SB, Chandy J. MRI appearances of multiple rice body formation in chronic subacromial and subdeltoid bursitis, in association with synovial chondromatosis. Clin Radiol. 2004;59(8):753-7. 

  7. Jeong YM, Cho HY, Lee SW, Hwang YM, Kim YK. Candida septic arthritis with rice body formation: a case report and review of literature. Korean J Radiol. 2013;14(3):465-9. 

  8. Chen A, Wong LY, Sheu CY, Chen BF. Distinguishing multiple rice body formation in chronic subacromial-subdeltoid bursitis from synovial chondromatosis. Skeletal Radiol. 2002;31(2): 119-21. 

  9. Muirhead DE, Johnson EH, Luis C. A light and ultrastructural study of rice bodies recovered from a case of date thorn-induced extra-articular synovitis. Ultrastruct Pathol. 1998;22(4): 341-7. 

  10. Nagasawa H, Okada K, Senma S, Chida S, Shimada Y. Tenosynovitis with rice body formation in a non-tuberculosis patient: a case report. Ups J Med Sci. 2009;114(3):184-8. 

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