Rice Bodies (RBs), named after their
macroscopic likeness in color, shape, and size to polished grains of rice, are
associated with chronic inflammatory processes, notably rheumatoid arthritis,
seronegative inflammatory arthritis,
and tuberculous joints.
In this report, a massive aggregate of rice bodies around a prosthetic hip was
clinically suspected to be a post-traumatic hematoma.
AlthoughRBs can normally be identified on T2-weighted MRI as hypointense
fusiform-shaped nodules floating free in a fluid background, in the present
case, the absence of a significant liquid milieu obscured RB detection. The
rarity of massive RB aggregates, a history of trauma, and its unusual
radiologic presentation due to an absence of significant joint fluid to
separate the RBs, motivated investigation into the etiology of RB formation in
the present case.
Thirty-sixmonths prior to presentation, the 66-year-old male patient underwent uncomplicated
total left hip replacement for advanced osteoarthritis. Seventy days following
left hip replacement, the patient resumed horseback riding 3-5 times a week for
a total of 40 hours per month. Sixteen months post-op for left hip arthroplasty
he developed moderate, intermittent, idiopathic lateral hip pain with
associated tenderness isolated in the trochanteric region and symptoms of
trochanteric bursitis. At twenty-eight months post-op, his horse bolted out
from under him as he tried to mount and the fall onto his left side led to
significant pain and marked swelling about the left knee. The knee improved
over the next few days but a newly appreciated area of swelling and marked
tenderness appearing over the left greater trochanter.
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