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Rice Bodies in Children with Rheumatic Disorders: A Case Series and Systematic Literature Review.

OBJECTIVES
Rice body (RB) formation is an uncommon inflammatory process seen in systemic disorders. In this study, we aimed to assess characteristic features of RBs in pediatric patients.


METHOD
We retrospectively evaluated pediatric patients who underwent joint/extremity magnetic resonance imaging (MRI). A systematic literature review was conducted for articles including children with RBs.


RESULTS
We found 24 patients (median age 6.1 years; F/M=2.4) with RBs [23 with juvenile idiopathic arthritis (JIA) and one with arthralgia]. The most prevalent location for RBs was the knee joint (75%). RBs were most frequently seen as diffuse multiple millimetric structures. In three out of five patients with follow-up MRI, resolution or regression of RBs was observed without surgical intervention. Our literature search identified 13 pediatric patients with RBs. Most (84.6%) had JIA, and the knee joint (71.4%) was the most commonly affected joint. Surgery was preferred in our three patients (12.5%) and ten literature patients (83.3%) in the treatment.


CONCLUSION
Our results showed that RBs were most commonly detected in the knee joint, and most cases were secondary to JIA. Although surgery is used as a treatment option, we observed that RBs can occasionally disappear during follow-up without surgical intervention.