Sonographic demonstration of hyperechoic fibrin coating of rice bodies in trochanteric bursitis: The "fried rice" pattern

Intra-articular rice body formation is generally related to synovial inflammatory conditions such as tuberculous, pyogenic, rheumatoid, or seronegative inflammatory diseases. Occasionally, it does not have any underlying disorder. Various mechanisms of pathogenesis of rice bodies have been proposed, including sloughing from the microinfarcted synovium, de novo formation in the synovial fluid, and entrapment of fibroblasts with collagen formation. Extra-articular rice body formation is unusual but may be found in bursitis or tenosynovitis. Here we report an unusual case of giant trochanteric bursitis with transmuscular dissection to the subcutaneous tissue and numerous intrabursal hypoechoic rice bodies with hyperechoic rim, simulating oil-coated fried rice. The usefulness of the sonographic probe compression technique for delineation of the dissection tract is emphasized, and the sonographic- histopathologic correlation of such a "fried rice" pattern is discussed.