MRI appearances of multiple rice body formation in chronic subacromial and subdeltoid bursitis, in association with synovial chondromatosis

Sonographic Demonstration of Hyperechoic Fibrin Coating of Rice Bodies in Trochanteric Bursitis

“…8 chondromatosis with hyperintense intra-articular cartilaginous nodules on T2-weighted MR images may be indistinguishable from rice bodies. 3,7,10,14,15 However, as demonstrated in our case, cautious identification of the so-called fried rice pattern can aid the discrimination of rice bodies from chondromatosis.…”

“…3,4 Rice bodies characteristically manifest as ovoid, freely movable, slightly hypointense to hyperintense intra-articular nodules on T2-weighted MR images. [7][8][9] On sonograms, rice bodies usually appear as isoechoic to hyperechoic nodules in the bursa and may mimic debris, blood, or viscous fluid. 8,9 In this particular case, sonograms revealed numerous intrabursal hypoechoic rice bodies with a hyperechoic rim, simulating oil-coated fried rice.…”

“…The differential diagnosis considerations of rice bodies include synovial osteochondromatosis, pigmented villonodular synovitis or other villonodular proliferative synovial diseases, and synovial chondromatosis. 3,4,[7][8][9][10] In contradistinction to rice bodies, synovial osteochondromatosis typically manifests as radiopaque nodules on radiographs, hyperechoic foci with acoustic shadows on sonograms, and hypointense or central fatlike intra-articular nodules on MR imaging. 10,[13][14][15][16] Pigmented villonodular synovitis or other villonodular proliferative synovial disease usually appears as synovial thickening with fixed mural nodules on sonograms, and pigmented villonodular synovitis usually appears as markedly hypointense nodules on MR imaging.…”

“…The clinical symptoms and synovial inflammatory changes may subside after effective removal of rice bodies by aspiration, lavage, or instillation of fibrinolysis-promoting agents such as urokinase. 2,7 Surgical intervention can be applied for infectious entities or in cases in which aspiration and lavage are unsuccessful. 14 In summary, this report describes an unusual case of giant trochanteric bursitis with transmuscular dissection to the subcutaneous tissue and intrabursal rice bodies.…”

Case report: biceps tenosynovial rice bodies

“…Plain radiographs are typically normal and help to differentiate uncalcified rice bodies from calcifications in synovial osteochondromatosis and chondrocalcinosis. Appearance on MRI is a function of size: small bodies may resemble a soft-tissue mass, debris, blood, or viscous fluid inside a bursa, and larger bodies appear as a ring enhancing loose bodies [8]. They may appear similar to pigmented villonodular in rheumatoid patients with cortical erosions, joint effusions, and hypertrophied pannus, but will lack the characteristic low signal on T2-weighted images owing to the hemosiderin.…”