Mass of the thenar eminence hiding idiopathic massive rice bodies formation with a compression of the median nerve: Case report and review of the literature

INTRODUCTION: Rice bodies are described as fibrin bodies usually found among patients with inflammatory joint diseases, tuberculous arthritis, and tuberculous tenosynovitis, but they are rarely found among non-tuberculosis patients. CASE PRESENTATION: We report a case of a 69-year-old with a 2-year history of swelling and pain of the thenar eminence of the left hand with paresthesia in the territory of the median nerve. Surgical exploration revealed multiple rice bodies. DISCUSSION: Several authors have speculated on the nature of rice bodies. Their presence is highly suggestive of tuberculous tenosynovitis. One case of a primary brucellar tenosynovitis has been reported. In Morocco, brucellosis and tuberculosis remain a significant problem, with synovial chondromatosis and pigmented villonodular synovitis as differential diagnoses. CONCLUSION: The patient had no history of tuberculosis, rheumatic disease, joint trauma, or infectious disease. Despite extensive evaluation, the etiology of the rice bodies could not be identified, and no underlying pathology was found.