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Rheumatoid or tubercular: Flexor tenosynovitis of the wrist with rice bodies.

ABSTRACT: Rice bodies are formed mainly in tenosynovitis and bursitis of rheumatoid or tubercular origin. It rarely presents with compressive ulnar neuropathy. A 35-year-old female presented with painful swelling in the volar aspect of the left wrist and incomplete flexion of the little finger. The laboratory tests revealed ESR 10 mm/1^st hr and C-reactive protein, rheumatoid factor, and anti-cyclic citrullinated peptide tests were negative. Thickened and distended ulnar bursa with rice bodies was seen on magnetic resonance imaging (MRI). Thorough drainage, debridement, and synovectomy were done. Epithelioid cell granulomas with multinucleated giant cells on microscopy and the strongly positive Mantoux test prompted us to start anti-tubercular treatment. The wound healed uneventfully with good recovery of range of motion of the little finger at one-year follow up. Rice bodies can be a diagnostic dilemma in the absence of classical signs of their rheumatoid or tubercular origin.

SUBMITTER: Tiwari P

PROVIDER: S-EPMC9810916 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Rheumatoid or tubercular: Flexor tenosynovitis of the wrist with rice bodies.

Tiwari Punit P Kaur Harmeet H Bansal Nitish N Jaura Sandeep Singh SS

Journal of family medicine and primary care 20221031 10

Rice bodies are formed mainly in tenosynovitis and bursitis of rheumatoid or tubercular origin. It rarely presents with compressive ulnar neuropathy. A 35-year-old female presented with painful swelling in the volar aspect of the left wrist and incomplete flexion of the little finger. The laboratory tests revealed ESR 10 mm/1<sup>st</sup> hr and C-reactive protein, rheumatoid factor, and anti-cyclic citrullinated peptide tests were negative. Thickened and distended ulnar bursa with rice bodies w ...[more]

PMID: 36618161

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