My initial reaction was, “What the heck is THAT? I don’t want to be the Sigourney Weaver of wound care!” The patient is a 30+ year survivor of high-dose radiation for a sarcoma over her right hip and thigh. She has terrible late effects of radiation, and the tissue over the thigh is breaking down. One day she came into clinic and when she moved her leg, these little guys poked their head out. I thought I’d seen it all, but I didn’t know what this was. An orthopedic surgery colleague was nonplussed when I described what I was looking at. As soon as he told me what they were, I thought, “Of course.” They are rice bodies! Usually you only see them in the operating room or on radiographic imaging. They don’t normally come out to greet you.
Rice bodies are small, oval-to-round masses of synovial origin that resemble polished grains of rice. They can number in the hundreds in the synovial fluid of the intraarticular space, and can also be found in bursae or tendon sheaths. They are caused by inflammatory processes and so are found in the joints of patients with rheumatoid arthritis, septic arthritis, systemic lupus, etc. This is probably a tendon sheath and the rice bodies “pop out” when she moves her leg up and down.