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Case Reports
. 2024 Apr 3:2024:8299485.
doi: 10.1155/2024/8299485. eCollection 2024.

Bilateral Subacromial-Subdeltoid Rice Bodies in the Shoulder: A Surgical Case Report

Caroline Rush  1 , Olivia Jochl  2 , Natalie Lowenstein  2   3 , Jillian Mazzocca  2 , Elizabeth Matzkin  4
Affiliations
Case Reports

Bilateral Subacromial-Subdeltoid Rice Bodies in the Shoulder: A Surgical Case Report

Caroline Rush et al. Case Rep Orthop. .

Abstract

Introduction: Rice bodies (RBs) are pale and glossy appearing small fibrinous nodules that form due to synovial or tenosynovial joint inflammation. RBs are significant as they are common in orthopedic practices causing nonspecific symptoms such as pain, swelling, range of motion limitations, crepitus, and catching sensations. These loose bodies occur often within the bursa as a symptom of chronic bursitis and are commonly associated with rheumatoid, inflammatory, or tuberculous arthritis. Reports on RBs are present; however, few bilateral cases within the shoulder appear in the literature. Case Presentation. This case demonstrates an unusual bilateral, subacromial-subdeltoid presentation of rice bodies (RBs) in a 41-year-old Caucasian female patient with a history of rheumatoid arthritis. We describe treatment with right shoulder arthroscopy to remove the loose bodies. One-year postoperative patient-reported outcomes (PROMs) show improvement in symptoms, pain, and overall function.

Conclusion: Formation of RBs occurs as a symptom of an inflammatory response in synovial joints. This provokes multiple small fibrin aggregates to collect within synovial bursae and occasionally tendon sheaths. RBs are rarely seen bilaterally. Arthroscopic removal of RBs is an appropriate treatment method for symptom improvement.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Right shoulder MRI. Magnetic resonance imaging (MRI) of the right shoulder of the patient preoperatively. The figure depicts three MRI images revealing multiple loose bodies within the subacromial space consistent with RB and a small, nontraumatic partial tear in the supraspinatus tendon, along with subacromial and subdeltoid bursitis.
Figure 2
Figure 2
Right shoulder arthroscopic images. Three intraoperative images from the patient of interest of the rice bodies in the subacromial space of the right shoulder.
Figure 3
Figure 3
Left shoulder MRI. Magnetic resonance imaging (MRI) of the left shoulder of the patient preoperatively. The figure depicts three MRI images revealing loose bodies within the subacromial and subdeltoid bursa.
Figure 4
Figure 4
Left shoulder arthroscopic images and loose bodies removed from the left shoulder. The first two images in this figure reveal intraoperative pictures from the patient of interest of the rice bodies in the left shoulder. The last image shows the loose rice bodies succeeding extraction.
See this image and copyright information in PMC

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