DEAR DR. GOTT: My healing wasn’t complete a year following rotator-cuff surgery. My shoulder became red and swollen. My doctor opened it up to see what was going on and found “rice bodies” — thousands of them. I understand this is a rare thing and that little is known about the cause or the treatment. I am specifically interested in knowing what antibiotics should be used. I am now on infusion therapy. Also, could these be elsewhere in my body?
DEAR READER: Identified and documented as far back as 1895, rice bodies were originally thought related to tuberculous arthritis. The name originated because of a similarity in appearance to grains of polished white rice.
Today, rice bodies are commonly linked with chronic rheumatoid arthritis (RA), as a complication of bursitis or an underlying systemic disorder. They appear to represent an unrelated group of particles that may contain fibrin, fibronectin, mononuclear and blood cells, collagen and amorphous materials.
Diagnosis is accomplished through X-ray, ultrasound or MRI. I cannot tell you which antibiotic to take because management depends on the underlying cause. For example, if your rice bodies are the result of chronic bursitis, an antibiotic may not be appropriate. Only your physician can direct you in that regard. Elimination of the offender in conjunction with treatment for any possible underlying disease should provide relief.
Infusion therapy is a means of administering medication through a needle or catheter intravenously. Infections and disorders unresponsive to oral medications, dehydration, diseases of the gastrointestinal tract, congestive heart failure and immune deficiencies are commonly handled through this form of therapy. Thirty years ago, patients being infused were required to remain in the hospital for the duration of the treatment. However, with expenses as they are in a hospital setting, the same service can now be provided in an outpatient setting or at home. I remember when a woman remained in hospital for close to a week following childbirth. Surgical patients undergoing relatively simple procedures spent almost the same amount of time recuperating before being sent home. Now, however, the sooner a patient returns to normal activity, the better.
Rice bodies can be found in joint areas such as the shoulder, knee or ankle. If your condition is the result of chronic bursitis or RA, multiple joints can be affected, but I can’t guess whether that will occur in your case.
To provide related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.