Presença de corpos riziformes em paciente com artrite idiopática juvenil: relato de caso e revisão de literatura

Abstract

Riziform bodies are structures formed by fibrin and cells that can be found in the synovial fluid or attached to the synovium, and have this denomination due to its rice grain-like appearance. They have already been described in several diseases such as tuberculous arthritis, rheumatoid arthritis, and rarely in juvenile idiopathic arthritis (JIA). This is the case of a boy with a 4-month course of chronic monoarthritis of the left knee, with family history of sarcoidosis in which diagnostic investigation showed the presence of these riziform bodies in the synovial biopsy. Diagnostic investigation ruled out sarcoidosis, tuberculosis and malignancies, establishing the diagnosis of JIA. Our objective was to describe what we believe is the 9th case reported on the presence of riziform bodies in JIA, which are probably underdiagnosed, and should be considered mainly in cases of severe arthritis of difficult medical treatment.

The Challenge of Tuberculosis Arthritis Differential Diagnosis

“…The reported child was referred to a rheumatologist with suspected juvenile idiopathic arthritis due to chronic monoarthritis and deformity in the lower limb. The differential diagnosis of monoarthritis in children must include septic arthritis, 15 especially due to M. tuberculosis , insidious involvement, little symptomatic profuse arthritis, slightly abnormal inflammatory tests, and negative RF. In 2 conditions, MRI can show extensive synovitis, which is a confounding factor in differential diagnosis, and that is why synovial biopsy and Tb culture are important, in addition to epidemiological history.…”