Rice bodies in a pediatric patient with juvenile idiopathic arthritis and latent tuberculosis: case report and literature review

INTRODUCTION Rice bodies, which are fragments composed of fibrin and collagen, ranging in appearance from white rice grains to yellow threads, represent a nonspecific response to inflammation. Rice bodies have been reported in cases of tuberculosis, systemic lupus erythematosus, rheumatoid arthritis, seronegative arthritis, and osteoarthritis. Found within joints, bursa, and tendon sheaths, the pathophysiology behind the formation of these corpuscles is unclear. A synovial membrane origin is suggested by blood vessels within corpuscles. Rice bodies are proposed to be pieces of synovium after inflammation andmicroinfarction, or fibrin aggregations independent of synovium. Although one study reported rice bodies in 72% of adult rheumatoid arthritis joints, rice bodies are rare in juvenile idiopathic arthritis. Few cases of rice bodies in the pediatric population have been reported across orthopaedic, pediatric, rheumatologic, and radiologic journals. We report an 11-year-old girl with extensive rice body formation who presented with atraumatic knee swelling in the setting of seronegative juvenile idiopathic arthritis and latent tuberculosis. Informed consent was obtained from the family.

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