Tuberculous Synovitis of the Elbow Presenting with Multiple Rice Bodies: A Rare Case Report

Musculoskeletal tuberculosis accounts for a minority of extrapulmonary tuberculosis cases, with the elbow being an uncommon site. Rice body formation, though described in rheumatoid arthritis and chronic synovitis, are rarely reported in tuberculous arthritis.

We describe a 70-year-old female presenting with progressive swelling and restriction of movement of the left elbow. Imaging revealed joint destruction with features suggestive of synovial chondromatosis, while biopsy and sputum studies were inconclusive. Surgical synovectomy revealed multiple intra-articular rice bodies, and histopathology confirmed tuberculous etiology. The patient received standard anti-tubercular therapy with physiotherapy, achieving pain relief and improved functional range of motion within 8 weeks.

This case highlights the diagnostic challenges of rice body tuberculosis, which may closely mimic other joint pathologies. Early surgical exploration, combined with anti-tubercular chemotherapy and rehabilitation, is essential for preventing irreversible joint damage and preserving function in rare extrapulmonary tuberculosis presentations.