{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:15:48Z","timestamp":1778652948125,"version":"3.51.4"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rice body synovitis (RBS), historically linked to tuberculosis, is increasingly recognized as an articular manifestation of autoimmune diseases in children, particularly Juvenile Idiopathic Arthritis (JIA). However, its diagnosis remains challenging and its management often fragmented between rheumatology and orthopedics. This study aims to characterize RBS within the spectrum of pediatric rheumatic disease and propose an integrated management framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of six pediatric patients (aged 2\u20139 years) with knee RBS, all of whom underwent arthroscopic debridement. Concurrently, a systematic literature review (2006\u20132026) was performed to synthesize global evidence on etiology, diagnosis, and treatment. Descriptive statistics were utilized to analyze the pooled cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In our cohort, RBS was associated with JIA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), tuberculosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), and non-specific synovitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094). Magnetic resonance imaging (MRI) demonstrated high diagnostic specificity, showing characteristic hypointense \u201crice bodies\u201d within hyperintense effusion on T2-weighted sequences. Surgical debridement provided immediate symptom relief, but recurrence occurred in the JIA patient, necessitating a combination of standard and biologic disease-modifying antirheumatic therapy (DMARD). Integrating literature data yielded a pooled cohort of 44 patients, confirming JIA as the predominant etiology (77.3%) in contemporary practice, highlighting an emerging trend moving away from strictly infectious to autoimmune origins.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RBS represents a rare but clinically significant articular phenotype within pediatric rheumatology, most commonly linked to JIA. Successful management requires a dual strategy: (1) MRI-guided early diagnosis and (2) a collaborative rheumatology-orthopedics approach combining arthroscopic intervention with targeted immunomodulatory therapy. Critically, the interpretation of etiology must be contextualized by geographical variability; while JIA predominates in developed nations, mycobacterial infections remain a paramount diagnostic priority in tuberculosis-endemic regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1801834","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:57:37Z","timestamp":1778651857000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rice body synovitis in children: a retrospective study of 6 cases and a systematic literature review of the last two decades (2006\u20132026)"],"prefix":"10.3389","volume":"14","author":[{"given":"Qiang","family":"Ren","sequence":"first","affiliation":[{"name":"Department of Emergency Surgery, Children\u2019s Hospital of Hebei Province; Hebei Provincial Clinical Research Center for Child Health and Disease","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Children\u2019s Hospital of Hebei Province; Hebei Provincial Clinical Research Center for Child Health and Disease","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuyang","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, North China Medical Health Group Xingtai General Hospital","place":["Xingtai, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Emergency, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuokang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Emergency, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanhua","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Children\u2019s Hospital of Hebei Province; Hebei Provincial Clinical Research Center for Child Health and Disease","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1093\/mrcr\/rxab040","article-title":"Rice bodies in the wrist","volume":"6","author":"Gillijns","year":"2022","journal-title":"Mod Rheumatol Case Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1186\/s12891-020-03563-0","article-title":"Hundreds of rice bodies in the subacromial-subdeltoid Bursa: report of two cases and literature review","volume":"21","author":"Guo","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"key":"B3","doi-asserted-by":"publisher","first-page":"947","DOI":"10.3904\/kjim.2023.103","article-title":"Rice body due to lupus","volume":"38","author":"Lin","year":"2023","journal-title":"Korean J Intern Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.2169\/internalmedicine.4671-20","article-title":"Non-tuberculosis mycobacterium tenosynovitis with rice bodies in a patient with systemic lupus erythematosus","volume":"59","author":"Fujieda","year":"2020","journal-title":"Int Med (Tokyo, Japan)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1136\/ard.41.2.109","article-title":"Frequency of occurrence, mode of development, and significance or rice bodies in rheumatoid joints","volume":"41","author":"Popert","year":"1982","journal-title":"Ann Rheum Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1002\/art.1780300618","article-title":"Subacromial bursitis with rice bodies as a presenting feature of seronegative rheumatoid arthritis","volume":"30","author":"Thevenon","year":"1987","journal-title":"Arthritis Rheum"},{"key":"B7","doi-asserted-by":"publisher","first-page":"11908","DOI":"10.12998\/wjcc.v10.i32.11908","article-title":"Idiopathic tenosynovitis of the wrist with multiple rice bodies: a case report and review of literature","volume":"10","author":"Tian","year":"2022","journal-title":"World J Clin Cases"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e17","DOI":"10.1097\/RHU.0000000000001206","article-title":"Fungal abscess mimicking ischiogluteal bursitis with rice bodies","volume":"27","author":"Ong","year":"2021","journal-title":"J Clin Rheumatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1136\/ard.53.6.427","article-title":"Rice bodies in the pleural aspirate of a patient with rheumatoid arthritis","volume":"53","author":"Kassimos","year":"1994","journal-title":"Ann Rheum Dis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"3760","DOI":"10.1097\/JS9.0000000000000940","article-title":"Preferred reporting of case series in surgery (PROCESS) 2023 guidelines","volume":"109","author":"Mathew","year":"2023","journal-title":"Int J Surg (London, England)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ (Clinical Research ed)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1391229","DOI":"10.3389\/fped.2024.1391229","article-title":"Rice body synovitis in pediatrics: three different case reports","volume":"12","author":"Wang","year":"2024","journal-title":"Front Pediatr"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e15184","DOI":"10.1111\/1756-185X.15184","article-title":"Polyarticular juvenile idiopathic arthritis with rice bodies formation: a case report","volume":"27","author":"Tang","year":"2024","journal-title":"Int J Rheum Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1093\/mr\/roac075","article-title":"Rice bodies in children with rheumatic disorders: a case series and systematic literature review","volume":"33","author":"Sener","year":"2023","journal-title":"Mod Rheumatol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"833","DOI":"10.7196\/SAMJ.2018.v108i10.13228","article-title":"Juvenile idiopathic arthritis flare due to rice bodies in the knee of a 10-year-old girl","volume":"108","author":"Faller","year":"2018","journal-title":"S Afr Med J"},{"key":"B16","first-page":"374","article-title":"A case of Candida septic arthritis with rice body formation in a 2-month-old infant","volume":"25","author":"d'Aleo","year":"2017","journal-title":"Infez Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.jpeds.2016.01.039","article-title":"Juvenile idiopathic arthritis with rice bodies in a 2-year-old girl","volume":"172","author":"Okura","year":"2016","journal-title":"J Pediatr"},{"key":"B18","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1097\/RHU.0b013e31826d6b5e","article-title":"Development of rice bodies in 2 children younger than 3 years","volume":"19","author":"Druschel","year":"2013","journal-title":"J Clin Rheumatol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/1752-1947-7-166","article-title":"Recurrent knee arthritis diagnosed as juvenile idiopathic arthritis with a 10-year asymptomatic period after arthroscopic synovectomy: a case report","volume":"7","author":"Teramoto","year":"2013","journal-title":"J Med Case Rep"},{"key":"B20","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1111\/j.1440-1754.2012.02420.x","article-title":"Rice bodies in juvenile idiopathic arthritis: a clinical image","volume":"48","author":"Cox","year":"2012","journal-title":"J Paediatr Child Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.ijscr.2011.07.001","article-title":"Bilateral recurrent wrist flexor tenosynovitis and rice body formation in a patient with sero-negative rheumatoid arthritis: a case report and review of literature","volume":"2","author":"Iyengar","year":"2011","journal-title":"Int J Surg Case Rep"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1007\/s00247-008-0978-7","article-title":"Juvenile idiopathic arthritis with rice bodies","volume":"38","author":"DiVito","year":"2008","journal-title":"Pediatr Radiol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1097\/01.bpb.0000228392.62678.df","article-title":"Case report: biceps tenosynovial rice bodies","volume":"15","author":"Cuomo","year":"2006","journal-title":"J Pediatr Orthop B"},{"key":"B24","doi-asserted-by":"publisher","first-page":"57","DOI":"10.25259\/IJMSR_38_2020","article-title":"Giant melon seed bodies in painless shoulder swelling","volume":"3","author":"Singh","year":"2021","journal-title":"Indian J Musculoskelet Radiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"4123","DOI":"10.2147\/IDR.S416990","article-title":"Candida parapsilosis-caused arthritis with rice body formation: a case presentation and literature review","volume":"16","author":"Qi","year":"2023","journal-title":"Infect Drug Resist"},{"key":"B26","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1136\/bmjebm-2017-110853","article-title":"Methodological quality and synthesis of case series and case reports","volume":"23","author":"Murad","year":"2018","journal-title":"BMJ Evid Based Med"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1801834\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:57:38Z","timestamp":1778651858000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1801834\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":26,"alternative-id":["10.3389\/fped.2026.1801834"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1801834","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"article-number":"1801834"}}