A Large Rice Body-Containing Cyst Mimicking Infection following Total Hip Arthroplasty: A Case Report

Abstract

Introduction Soft tissue mass following total hip arthroplasty raises several differential diagnoses not limited to infection, hematoma, wear debris, malignancy, and bursitis. Rice body formation in the hip region is an uncommon process denoting a chronic inflammation. We report here the second case of its kind in the medical literature of a wide symptomatic rice-like body cyst complicating a total hip arthroplasty. Case Presentation This is the case of an 82-year-old white female, presenting with a warm, red, and inflated groin five years after revision of right total hip arthroplasty. Surgical intervention reveals a large well circumscribed cyst containing well-organized rice-like bodies. This eventuality was never reported in differential diagnosis of hip periprosthetic soft tissue masses before. Conclusion This case report helps widening the array of the differential diagnosis in patients presenting with a slow growing soft tissue mass following total hip arthroplasty, making rice-like bodies cyst a valid one to consider.

Stenosing tenosynovitis with rice bodies formation diagnosed by ultrasound

“… [7] Some scholars have found a large number of rice bodies in the capsule of patients with chronic infection after hip arthroplasty, which indicates that rice bodies can also form after chronic infection. [8] It can be seen that rice bodies like structures can form in different diseases, and there are some differences between the formation mechanisms and components of these rice bodies. In our case, rice body synovitis in the tendon sheath of the flexor tendons of the right hand was rare, and the patient had no history of rheumatoid arthritis, tuberculosis, or other diseases, which were considered primary lesions.…”

“…Studies have speculated that rice bodies may be associated with fibroblasts encapsulated and activated by cellulose, which, in turn, produces collagen [7] . Some scholars have found a large number of rice bodies in the capsule of patients with chronic infection after hip arthroplasty, which indicates that rice bodies can also form after chronic infection [8] . It can be seen that rice bodies like structures can form in different diseases, and there are some differences between the formation mechanisms and components of these rice bodies.…”

Rice body formation due to Haemophilus parainfluenza-associated chronic arthropathy

“…They generally form as a nonspecific response to chronic inflammatory arthropathy and tend to occur in synovial fluid, particularly of the knee, bursae and, less frequently, tendon sheaths [ 2 , 3 ]. Although there is no clear correlation, RBF associated with psoriatic arthritis or orthopedic hardware placement has been reported in a handful of cases in the literature [ 4 ]. After a thorough literature review, we did not find any cases of RBF attributable to H. parainfluenzae infection and is what sets this case apart from the previous cases of this disease.…”

“…Magnetic resonance imaging (MRI) imaging is now the modality of choice for evaluating rice bodies. They exhibit hypointense signals on both T1 and T2-weighted sequences [ [1] , [2] , [3] , [4] ]. Differential diagnosis includes synovial osteochondromatosis and pigmented villonodular synovitis (PVNS).…”

Exuberant Rice Body Formation Associated with Adverse Local Tissue Reaction After Hip Resurfacing Arthroplasty

“…Filamentous strands of fibrin in the form of fibrinous loose bodies occasionally have a rice-like gross appearance and have been termed "rice bodies" 2 . Rice bodies have been associated with mycobacterial infections 3 , autoimmune disease 4 , other types of infection [5][6][7][8][9][10][11] , and orthopaedic implants 1,[12][13][14][15][16] . We present the case of a man who developed periprosthetic rice bodies 3 years after metal-on-metal hip resurfacing arthroplasty (HRA).…”