Medicine · 2026
Rice body synovitis of the wrist mimicking tuberculosis in an HIV-positive patient: A case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Zhou Bo, Luo Shanpeng, Yan Xin, Liao Chunyuan, Feng Jiayi, Chen Yangyang
Аннотация
RATIONALE: Rice body synovitis is a rare benign synovial disorder with an insidious onset and nonspecific clinical features that often lead to diagnostic uncertainty or delay.
PATIENT CONCERNS: A 68-year-old woman with human immunodeficiency virus infection and a history of cured pulmonary tuberculosis presented with right wrist pain and swelling for 3 years, which had worsened over the preceding 2 months. She also reported limited motion and a palpable mass.
DIAGNOSES: Preoperative imaging showed moth-eaten bone destruction, peri-articular abscesses, joint space narrowing, and intra-articular rice bodies, raising a strong suspicion of tuberculous arthritis. However, intraoperative assessment and histopathological analysis confirmed rice body synovitis and found no evidence of Mycobacterium tuberculosis infection or granulomatous inflammation.
INTERVENTIONS: Surgical exploration and synovectomy were performed, various intra-articular bodies were removed, and the affected tissues were debrided.
OUTCOMES: The patient recovered well after surgery, with significant symptom relief and improved joint function. No recurrence was observed during 8 months of follow-up.
LESSONS: In regions where tuberculosis is prevalent, clinicians should avoid diagnosing tuberculous synovitis solely based on intra-articular bodies or radiographic abnormalities, even in high-risk patients. Histopathological evaluation is essential for definitive diagnosis and appropriate management.
PATIENT CONCERNS: A 68-year-old woman with human immunodeficiency virus infection and a history of cured pulmonary tuberculosis presented with right wrist pain and swelling for 3 years, which had worsened over the preceding 2 months. She also reported limited motion and a palpable mass.
DIAGNOSES: Preoperative imaging showed moth-eaten bone destruction, peri-articular abscesses, joint space narrowing, and intra-articular rice bodies, raising a strong suspicion of tuberculous arthritis. However, intraoperative assessment and histopathological analysis confirmed rice body synovitis and found no evidence of Mycobacterium tuberculosis infection or granulomatous inflammation.
INTERVENTIONS: Surgical exploration and synovectomy were performed, various intra-articular bodies were removed, and the affected tissues were debrided.
OUTCOMES: The patient recovered well after surgery, with significant symptom relief and improved joint function. No recurrence was observed during 8 months of follow-up.
LESSONS: In regions where tuberculosis is prevalent, clinicians should avoid diagnosing tuberculous synovitis solely based on intra-articular bodies or radiographic abnormalities, even in high-risk patients. Histopathological evaluation is essential for definitive diagnosis and appropriate management.