Rice bodies in a shoulder bursa: a cadaveric and histologic case report

ABSTRACT

Introduction

The subacromial/subdeltoid bursa can develop inflammation and effusion related to autoimmune, infectious, and musculoskeletal disorders. Rice bodies, or loose bodies within bursa, have been described as an uncommon complication of bursitis and have been the subject of case studies over a number of years. However, they have not been described in anatomical or physical therapy-related literature.

Methods

A donor body dissected for a physical therapy anatomy course was found to have an enlarged subacromial/subdeltoid bursa. This bursa, along with the biceps brachii tendon sheath, and the subscapularis muscle bursa, were filled with numerous rice-like bodies. The bursal wall was well developed and thickened. Tissue specimens were obtained of the suspected rice bodies, the subacromial/subdeltoid bursal wall, and the biceps brachii tendon sheath. The tissue was embedded, sectioned, and processed with hematoxylin and eosin or Masson’s Trichrome staining for blinded histologic assessment.

Results

The tissue samples from within the bursa were identified as tissue similar to that in prior descriptions of rice bodies. Tissue samples from the bursal wall and tendon sheath were identified as similar to synovial membranes.

Conclusions

Rice bodies found within the cadaveric body were similar histologically to those described in rheumatology, radiology, and orthopedic literature. Anatomists teaching future health-care providers and practicing physical therapists should be familiar with rice bodies as a potential finding in cadavers, and patients.

KEYWORDS:

• Sub-acromial bursitis
• cadaver
• histology
• case report
• loose body

Acknowledgments

We would like to thank our donor and their family for their gift to anatomical education and research. We acknowledge the procurement agency for permission to photograph the donor body. We also thank the Gannon University Faculty Research Committee for their financial support of this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Gannon Univeristy Faculty Research Committee under Grant [number 101-0000-21339]

Notes on contributors

Donna L. Skelly

Donna L. Skelly is an Associate Professor in the Morosky College of Health Professions and Sciences at Gannon University in Erie, Pennsylvania. She earned her bachelor’s degree in physical therapy and Masters in orthopaedic physical therapy from the University of Pittsburgh, and a PhD in physical therapy from Nova Southeastern University. She has taught anatomy, biomechanics, and musculoskeletal examination and treatment in the entry-level physical therapy program for over 20 years. She has 38 years of clinical experience in orthopaedic physical therapy continuing practice in a limited capacity in addition to teaching. She is a member of the APTA, the Orthopaedic and Education Academies, AAOMPT and the American Association for Anatomy. Research interests include anatomic findings, application of clinical practice guidelines, orthopaedic physical therapy management and ergonomics.

Elisa M. Konieczko

Elisa M. Konieczko is a Professor of biology in the Morosky College of Health Professions and Sciences at Gannon University in Erie, Pennsylvania, where she has taught cadaver-based Human Gross Anatomy, Anatomy and Physiology I and II, Cell Biology, and Histology, among other courses. Dr. Konieczko earned her Bachelor of Science degree in biology from Gannon University and her Doctor of Philosophy degree in neurobiology, anatomy, and cell science from the University of Pittsburgh School of Medicine. Dr. Konieczko’s current research interests are focused on two different areas: 1) the effects of alcohol, diabetes, and obesity on human skeletal muscle, and 2) biomedical undergraduate pedagogy. She is a member of the American Association for Cell Biology (ASCB), the American Association for Anatomy (AAA), and the Pennsylvania Academy of Science. She currently serves on the ASCB’s Honorific Awards Task Force.

Jonathan Ulrich

Jonathan Ulrich is an Assistant Teaching Professor in the Morosky College of Health Professions and Sciences at Gannon University in Erie, Pennsylvania. He earned his bachelor’s in rehabilitation science from Northeastern University, his master’s degree in physical therapy from Northeastern University, and his doctorate in physical therapy from Shenandoah University. He is currently pursuing a PhD in organizational learning and leadership at Gannon University. He has taught anatomy, biomechanics, musculoskeletal examination and treatment, and healthcare policy systems and management in the entry-level physical therapy program for four years. He has 16 years of clinical experience and continues to practice in both the acute care and outpatient orthopedic/sports settings. He is a member of the APTA, APTA PA, and the Orthopedic, Sports, Leadership and Innovation, and Education Academies. Research interests include anatomic findings, pain neuroscience education, and leadership in physical therapy.