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Tuberculous subdeltoid bursitis with rice bodies
Ryuh-Sup Kim1, Joung-Yoon Lee, Sae-Rom Jung
1Department of Orthopedic Surgery, In Ha University Hospital, 7-206, 3-Ga, Shinheung-Dong, Jung-Gu, Inchon 400-103, Korea. keelim@inha.ac.kr
Yonsei Medical Journal
|September 3, 2002
Summary
Tuberculosis can cause shoulder swelling and pain, presenting as subdeltoid bursitis with rice bodies. This case highlights a rare presentation of isolated tuberculous bursitis without bone or joint involvement.
Area of Science:
- Orthopedics
- Infectious Diseases
- Rheumatology
Background:
- Subdeltoid bursitis is a common cause of shoulder pain.
- Rice bodies are occasionally found in bursitis but are rare in tuberculous cases.
- Tuberculosis (TB) typically affects bones and joints, but isolated bursal TB is exceptionally rare.
Observation:
- A 41-year-old woman presented with a 2-month history of right shoulder swelling and pain.
- Magnetic resonance imaging (MRI) revealed subdeltoid bursitis and rice bodies.
- Arthroscopic debridement and biopsy were performed due to persistent symptoms.
Findings:
- Histologic examination showed granulomatous tissue with caseous necrosis.
- Culture of Mycobacterium tuberculosis confirmed tuberculous subdeltoid bursitis.
- The patient had isolated bursal TB without active bone or joint TB.
Implications:
- This case underscores the importance of considering tuberculosis in the differential diagnosis of shoulder bursitis, especially with rice body formation.
- Early diagnosis and treatment of tuberculous bursitis are crucial to prevent potential joint damage.
- Further research into the pathogenesis of isolated tuberculous bursitis and rice body formation is warranted.