title: [Tuberculous rice body synovitis of the shoulder joint].
abstract: The clinical presentation of synovitis with rice bodies is found in a few systemic diseases as accompanying manifestations within joints or joint-associated bursa. A 79-year old patient was examined, who had complained of pain and swelling in the left shoulder for a long time. Sonography identified multiple spindle-shaped joint bodies within the joint effusion. MRI showed a large amount of so-called rice bodies with joint effusion in the shoulder and a massive destruction of the rotator cuff of the left shoulder. The histological examination showed a tuberculosis-specific inflammatory response with giant cells and epithelioid granulomas and molecular biological detection of Mycobacterium tuberculosis. Within a few months after surgical removal of the rice bodies from the joint space and the bursa a relapse occurred with repeated synovial effusion followed by a renewed surgical removal of the joint bodies. We describe the rare case of a patient with unilateral musculoskeletal manifestation of tuberculosis presented as synovitis of the left shoulder and the adjacent bursa with rice bodies and accelerated growth trend without coexisting active tuberculosis or tuberculosis in the previous history. Furthermore, a brief summary of the literature is given.
authors.affiliation: BG-Klinikum Bergmannsheil GmbH, Universitätsklinikum der Ruhr-Universität, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland. m.koenigshausen@web.de
authors.forename: M
authors.initials: M
authors.lastname: Königshausen
authors.forename: D
authors.initials: D
authors.lastname: Seybold
authors.forename: C M
authors.initials: CM
authors.lastname: Heyer
authors.forename: G
authors.initials: G
authors.lastname: Muhr
authors.forename: C
authors.initials: C
authors.lastname: Gekle
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D012785:Shoulder Joint / Q000473:pathology*; D013585:Synovitis / Q000473:pathology*; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis*
references.citation: J Rheumatol. 1981 Jan-Feb;8(1):165-8
references.pmid: 7218248
references.citation: Ryumachi. 1983 Aug;23(4):206-11
references.pmid: 6665638
references.citation: Arthritis Rheum. 1977 Sep-Oct;20(7):1343-9
references.pmid: 334184
references.citation: J Bone Joint Surg Am. 1996 Feb;78(2):288-98
references.pmid: 8609123
references.citation: Radiology. 1996 Nov;201(2):507-13
references.pmid: 8888250
references.citation: Arthritis Rheum. 2005 Jun;52(6):1950
references.pmid: 15934133
references.citation: Mayo Clin Proc. 1969 Feb;44(2):73-80
references.pmid: 5764795
references.citation: Arthritis Rheum. 1987 Jun;30(6):715-6
references.pmid: 3606687
references.citation: Arthritis Rheum. 1978 Jan-Feb;21(1):145-7
references.pmid: 623684
references.citation: Yonsei Med J. 2002 Aug;43(4):539-42
references.pmid: 12205745
references.citation: Skeletal Radiol. 2004 Sep;33(9):531-3
references.pmid: 15483755
references.citation: Radiol Clin North Am. 1995 Jul;33(4):679-89
references.pmid: 7610238
references.citation: Arthritis Rheum. 1980 Jan;23(1):72-6
references.pmid: 7352946
references.citation: AJR Am J Roentgenol. 2003 May;180(5):1455-9
references.pmid: 12704068
references.citation: Skeletal Radiol. 2002 Feb;31(2):119-21
references.pmid: 11828336
references.citation: J Bone Joint Surg Am. 1980 Oct;62(7):1194-6
references.pmid: 7430208
references.citation: Clin Orthop Relat Res. 1985 Apr;(194):185-8
references.pmid: 3978914
references.citation: Clin Orthop Relat Res. 1994 Apr;(301):185-90
references.pmid: 8156671
references.citation: AJR Am J Roentgenol. 1998 Mar;170(3):698-700
references.pmid: 9490956
references.citation: Ultrastruct Pathol. 1998 Jul-Aug;22(4):341-7
references.pmid: 9805359
references.citation: Clin Radiol. 1996 Jul;51(7):511-4
references.pmid: 8689829
references.citation: Ann Rheum Dis. 1979 Feb;38(1):8-13
references.pmid: 434952
references.citation: Ann Rheum Dis. 1982 Apr;41(2):109-17
references.pmid: 6176192
references.citation: Skeletal Radiol. 1993;22(1):71-3
references.pmid: 8430351
references.citation: Ann Intern Med. 1969 Jan;70(1):61-8
references.pmid: 5763729