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Introduction <p>Rice bodies are rare intra-bursal structures usually associated with chronic synovial inflammation and may be observed in rheumatologic or infectious conditions. This case report is unique because we describe a case of shoulder pain in which rice bodies were undetectable on Magnetic resonance imaging (MRI) but were clearly identified using ultrasonography (US), with US-guided intrabursal steroid injection providing symptomatic relief.</p> Case Presentation <p>We report a case of a 48-year-old male presenting with rice body subacromial–subdeltoid bursitis. Our patient presented to the clinic with a two-month history of left shoulder pain, crepitus, and a sensation of catching during movement. (MRI) demonstrated subacromial–subdeltoid bursitis but failed to detect rice bodies. Diagnostic US revealed multiple small, hyperechoic nodules within the bursa. Laboratory and rheumatologic evaluations, including an infectious work-up, were unremarkable. The patient declined surgical management; therefore, US-guided local corticosteroid injection was administered, resulting in significant short-term improvement in pain and function. Histopathology of aspirated bursal fluid confirmed mild active bursitis.</p> Conclusions <p>In patients with identified rice bodies who decline surgery, local corticosteroid therapy appears to provide short-term symptomatic benefit; however, further studies are required to evaluate long-term efficacy and sustainability. This case highlights the value of ultrasonography as a complementary diagnostic tool and the potential of minimally invasive corticosteroid therapy in selected patients.</p>

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Rice Body Formation Detected by Ultrasonography in Subacromial–subdeltoid Bursitis Overlooked by MRI: A Case Report

  • 期刊论文

  • 发表日期：

    2026年3月3日

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  • Esra Giray,
  • Sena Sofuoglu,
  • Aslinur Keles,
  • Ozge Gulsum Illeez,
  • Emine Celik Tellioglu,
  • Engin Ciğercioğulları

摘要

Introduction

Rice bodies are rare intra-bursal structures usually associated with chronic synovial inflammation and may be observed in rheumatologic or infectious conditions. This case report is unique because we describe a case of shoulder pain in which rice bodies were undetectable on Magnetic resonance imaging (MRI) but were clearly identified using ultrasonography (US), with US-guided intrabursal steroid injection providing symptomatic relief.

Case Presentation

We report a case of a 48-year-old male presenting with rice body subacromial–subdeltoid bursitis. Our patient presented to the clinic with a two-month history of left shoulder pain, crepitus, and a sensation of catching during movement. (MRI) demonstrated subacromial–subdeltoid bursitis but failed to detect rice bodies. Diagnostic US revealed multiple small, hyperechoic nodules within the bursa. Laboratory and rheumatologic evaluations, including an infectious work-up, were unremarkable. The patient declined surgical management; therefore, US-guided local corticosteroid injection was administered, resulting in significant short-term improvement in pain and function. Histopathology of aspirated bursal fluid confirmed mild active bursitis.

Conclusions

In patients with identified rice bodies who decline surgery, local corticosteroid therapy appears to provide short-term symptomatic benefit; however, further studies are required to evaluate long-term efficacy and sustainability. This case highlights the value of ultrasonography as a complementary diagnostic tool and the potential of minimally invasive corticosteroid therapy in selected patients.