Bacha Raham, Manzoor Iqra, Gilani Syed Amir
University Institute of Radiological Sciences and Medical Imaging Technologies (UIRSMIT), Faculty of Allied Health Sciences (FAHS), The University of Lahore, Lahore, Pakistan.
University Institute of Radiological Sciences and Medical Imaging Technologies (UIRSMIT), The University of Lahore, G 10\2 Canal Berg, Lahore, 54000, Pakistan.
Ultrasound J. 2019 Jul 22;11(1):16. doi: 10.1186/s13089-019-0130-y.
subacromial-subdeltoid chronic bursitis is one of the main causes of shoulder pain syndrome. There are various causes of shoulder pain syndrome including chronic bursitis. The sonographic appearances of chronic bursitis vary from patient to patient, depending upon the underlying cause. However, rice bodies are the rare sonographic presentation among them. Rice bodies can be associated with atypical mycobacterial tenosynovitis, bursitis, mycobacterium tuberculosis and infections, but very rarely occur in the chronic subacromial-subdeltoid bursitis. Its unique sonographic presentation makes it easy to be diagnosed confidently, but it is difficult to be recognized, interpret and distinguish from other pathologies due to its rare occurrence. It is therefore intended to present this rare and interesting sonographic presentation of chronic subacromial-subdeltoid bursitis as a case report.
CASE-PRESENTATION: A 36-year-old male suffering from swelling and pain on his left shoulder for 6 months came to the clinic with Grade-3 impingement syndrome. Free-floating echogenic rice bodies were identified in the subacromial-subdeltoid bursa during ultrasound examination, which was also confirmed with Magnetic resonance imaging (MRI) and serological tests of the specimen after surgery.
The unique sonographic presentation of rice bodies in the chronic subacromial-subdeltoid bursitis makes it easy to be diagnosed confidently, but it is difficult to be recognized, due to its rare occurrence.
肩峰下-三角肌下滑囊炎是肩部疼痛综合征的主要病因之一。肩部疼痛综合征有多种病因,包括慢性滑囊炎。慢性滑囊炎的超声表现因潜在病因不同而因人而异。然而,米粒体是其中罕见的超声表现。米粒体可与非典型分枝杆菌腱鞘炎、滑囊炎、结核分枝杆菌及感染相关,但在慢性肩峰下-三角肌下滑囊炎中极为罕见。其独特的超声表现使其易于确诊,但因其罕见,难以识别、解读并与其他病变相区分。因此,本文旨在以病例报告的形式呈现慢性肩峰下-三角肌下滑囊炎这种罕见且有趣的超声表现。
一名36岁男性,左肩肿胀疼痛6个月,因Ⅲ级撞击综合征前来就诊。超声检查时在肩峰下-三角肌下滑囊中发现了游离的高回声米粒体,术后标本的磁共振成像(MRI)及血清学检查也证实了这一发现。
慢性肩峰下-三角肌下滑囊炎中米粒体独特的超声表现使其易于确诊,但因其罕见,难以被识别。