A Rare Case of Multiple Rice Bodies in Glenohumeral Joint, Subscapular Recess and Along Long Head of Biceps

Giant Extra-Articular Synovial Chondromatosis of the Ankle Joint - A Rare Case Report

INTRODUCTION

Synovial chondromatosis (SC) commonly involves large joints such as the knee and hip with smaller joints being less frequently involved. Extra-articular involvement is very rare, and here, we are presenting the first case of giant extra-articular SC originating from the ankle joint.

CASE REPORT

A 42-year-old male presented to the outpatient department with painless swelling over the lateral malleolus for 2 years. Diagnostic imaging suggested the involvement of the synovial lining with the swelling. The mass was excised and histopathology proved the diagnosis of SC.

CONCLUSION

Extra-articular involvement in SC has been mainly reported in the synovial sheath or bursae of the hand and foot, but they can involve ankle joint also. In recent times, there have been concerns about potential malignant transformation of these lesion to chondrosarcoma, diagnosing these lesions have become important.

Arthroscopic Treatment of Primary Synovial Chondromatosis of the Subscapular Bursa: A Case Report

Introduction

Synovial chondromatosis is a rare metaplastic disorder of the synovial membrane. Primary synovial chondromatosis of the shoulder joint is a rare localization and extra-articular localization around the shoulder is much less common.

Case Report

We report a rare case of a 13-year-old boy with primary synovial chondromatosis of the subscapular bursa. Computed tomography and magnetic resonance imaging showed that multiple cartilaginous loose bodies were found in the subscapular bursa and the glenohumeral joint. Arthroscopic removal of loose bodies and synovectomy of the subscapular bursa was performed through sublabral foramen.

Conclusion

Pre-operative investigation for the precise location of the lesions was important for the planning the operative procedure. Arthroscopic removal of loose bodies and synovectomy was useful treatment options for synovial chondromatosis of the subscapular bursa.

Sonographic presentation of rice bodies in subacromial-subdeltoid chronic bursitis

Background

subacromial-subdeltoid chronic bursitis is one of the main causes of shoulder pain syndrome. There are various causes of shoulder pain syndrome including chronic bursitis. The sonographic appearances of chronic bursitis vary from patient to patient, depending upon the underlying cause. However, rice bodies are the rare sonographic presentation among them. Rice bodies can be associated with atypical mycobacterial tenosynovitis, bursitis, mycobacterium tuberculosis and infections, but very rarely occur in the chronic subacromial-subdeltoid bursitis. Its unique sonographic presentation makes it easy to be diagnosed confidently, but it is difficult to be recognized, interpret and distinguish from other pathologies due to its rare occurrence. It is therefore intended to present this rare and interesting sonographic presentation of chronic subacromial-subdeltoid bursitis as a case report.

Case-presentation

A 36-year-old male suffering from swelling and pain on his left shoulder for 6 months came to the clinic with Grade-3 impingement syndrome. Free-floating echogenic rice bodies were identified in the subacromial-subdeltoid bursa during ultrasound examination, which was also confirmed with Magnetic resonance imaging (MRI) and serological tests of the specimen after surgery.

Conclusion

The unique sonographic presentation of rice bodies in the chronic subacromial-subdeltoid bursitis makes it easy to be diagnosed confidently, but it is difficult to be recognized, due to its rare occurrence.

Electronic supplementary material

The online version of this article (10.1186/s13089-019-0130-y) contains supplementary material, which is available to authorized users.