Sara

[♡ @loversphotos]

home feels warm

[Sara @Sararishell20]

Seré la única penonomeña a la que no le gustan los dulces de la Chelita?

[Ekkanss @ekkanss]

Yo en el baño esperando que la ducha me quite toda mi tristeza y ansiedad:

[Sara @Sararishell20]

Bendita sea la piña, que fruta tan riica

[Sara @Sararishell20]

Llevo casi toda mi vida deseando tener un abdomen plano, que trauma.

[Sara @Sararishell20]

Mi gato y yo, yo y mi gato

[Mastering the Differential 🩺 @MTD_MED]

Rice Body Synovitis 🍚
This striking illustration shows a surgical exploration of the palm/wrist revealing a cavity packed with hundreds of small, white, oval-shaped loose bodies — the classic "rice bodies" of rice body synovitis.

Rice bodies are small, free-floating fibrinous bodies found within joint spaces, bursae, or tendon sheaths. They get their name from their uncanny resemblance to polished white rice grains, and seeing them spill out intraoperatively — as shown here — is one of the most visually memorable findings in musculoskeletal medicine.

They form through a process of synovial microvillous infarction. The inflamed synovium sheds small fragments that then get coated with fibrin and collagen, rounding off over time into those characteristic oval shapes. They are avascular and metabolically inert, which is why they accumulate silently over months to years before causing significant symptoms.

Clinically, patients typically present with a slowly enlarging, doughy or boggy swelling around a joint or tendon sheath — most commonly the wrist, knee, shoulder, or olecranon bursa. The swelling is often surprisingly painless given its size, and that discrepancy between bulk and discomfort is actually a useful diagnostic clue. On ultrasound, the joint effusion appears filled with multiple echogenic foci, giving a classic "snowstorm" appearance. MRI shows the bodies as low signal on all sequences, floating within the effusion.

The condition is strongly associated with tuberculosis — and in endemic regions, TB synovitis should be the first thing on your differential. However, rice bodies are also well documented in rheumatoid arthritis, seronegative arthropathies, and occasionally in otherwise healthy individuals with no identifiable cause (idiopathic). This is why workup should always include TB testing (Mantoux, IGRA, synovial biopsy with AFB culture), as well as rheumatological screening.

Treatment depends on the underlying cause. TB-associated disease requires full anti-tuberculous therapy. Inflammatory arthritis is managed accordingly. When the rice bodies are causing mechanical symptoms, compressive neuropathy (like carpal tunnel, as the wrist is a common site), or the bursa is massively distended, surgical synovectomy and washout — exactly what's depicted in this image — is the definitive intervention. The bodies are scooped and irrigated out, and the inflamed synovium is resected to reduce recurrence.

The key teaching point: never dismiss a boggy, chronically swollen joint as "just a cyst." Rice body synovitis is a diagnosis that carries real systemic implications, and missing TB in that context is a costly mistake. 🔬

[Sara @Sararishell20]

Que linda que es la vida, te lo digo mi vida

[Diana M. Pamela Tejeira Yáñez 🌳 @Pamelatejeira16]

Necesitamos pintas de sangre para mi papá! Se cubren los gastos de ser necesario
Banco de Sangre del Rafael Estevez trabaja de lunes a viernes de 8:00 am a 12:00 md

[Diana M. Pamela Tejeira Yáñez 🌳 @Pamelatejeira16]

Seguimos en búsqueda de donantes O- para mi papá, ayúdame compartiendo!

[Sara @Sararishell20]

Quiero una wafflera

[ANIMALITOS SANADORES @ANIMALITOSSANA]

Hoy descubrí que no está conmigo por dinero.

[Sara @Sararishell20]

Cómo asi que mañana no es sábado

[Vive con Propósito. @PropositoyVida]

A medida que uno envejece, se da cuenta cada vez más de que la verdadera felicidad se compone de mañanas tranquilas, un entorno limpio, acostarse temprano, un hogar seguro y personas que no te agoten la energía...

[🥀🩸🥀 @WinterFire__]

Mientras una esté viva, una debe besar a sus michis en su cabecita lo más que pueda.

[The Notorious J.O.V. @whotfisjovana]

precisely

[Sara @Sararishell20]

Amo las mañanas lentas y en total paz