Introduction: Rice-body formation is most commonly associated with inflammatory arthropathies such as rheumatoid arthritis or tuberculosis infection, its occurrence in “idiopathic” or degenerative conditions is rare. However, a small number of case reports have described rice body formation in the absence of systemic inflammatory disease. We describe a case of rice-body formation in a 74-year-old male who presented with spontaneous rupture of multiple extensor digitorum communis (EDC) tendons. Intraoperatively found to have extensive rice-body synovitis and associated extensor tendon rupture, despite no previous history of rheumatic disease or infection. This case highlights an unusual aetiology of extensor tendon rupture and suggests the pathophysiology of rice bodies remains poorly understood. Case: A 74-year-old right hand dominant, retired tiler, male patient presented to the Plastics Surgery Outpatient Clinic (Sir Charles Gairdner Hospital, Australia) with spontaneous right index, ring and little finger extensor tendon rupture. The patient underwent right wrist synovectomy, buddy repair of right ring and little finger EDC tendons and adipofascial graft. During the operation, erosion of the dorsal capsule overlying the lunate body was noted. Multiple rice bodies within the EDC sheath were identified. Complete rupture of right index, ring and little finger EDC tendons identified. Discussion/Conclusion: The pathophysiology of rice body formation remains unknown. Although rare, we have presented a case of a 74 year-old man with rice body formation in the extensor tendons/retinaculum without association to any inflammatory disease such as tuberculosis or rheumatoid arthritis. Clinicians should keep in mind that spontaneous extensor tendon rupture can occur associated with synovitis with rice body formation in the degenerative wrist.