Rice Bodies in Juvenile Rheumatoid Arthritis
Rice bodies, named after their macroscopic likeness to polished grains of rice, were first described in the literature more than a century ago in association with Tuberculous arthritis. More recently, their presence has been linked to chronic inflammatory processes, notably rheumatoid arthritis. Though the macroscopic and microscopic appearance of rice bodies and their clinical associations and significance have been discussed in the rheumatology literature, few cases have been documented in the pediatric population. In addition, a few descriptions exist of the imaging characteristics of rice bodies but, to our knowledge, none of them about children. Our case shows an atypical presentation of juvenile rheumatoid arthritis with rice bodies as a painful soft-tissue mass. A 4 yr. old boy presented with a painful swelling of right knee for 2 months, MRI was done and rice bodies were seen in response to synovial inflammation in MRI and surgical evacuation which resulted in gush of synovial fluid and intraarticular bodies which is confirmed in biopsy.