Rice-body formation and tenosynovitis of the wrist: a case report

Abstract

A 61-year-old woman presented with mild pain and swelling on the volar aspect of the wrist, hand, and little finger. Radiography showed a soft-tissue mass shadow, and magnetic resonance imaging showed acute tenosynovitis of the flexor tendons and an inflammatory mass inside the carpal tunnel. Laboratory test results were normal, except for an elevated erythrocyte sedimentation rate (40 mm/h). The patient had an ambiguous Mantoux test result but no history of mycobacterial exposure. Exhaustive investigations for rheumatic disease were negative. Surgical exploration of the lesion revealed rice bodies in the common flexor tendon synovial sheath, extending distally to the tip of the fifth finger. Removal of the rice bodies and thorough excision of the sheath was performed. The patient regained a full and painless range of motion in about 3 months. One-year follow-up revealed no underlying disorder.