We thank the author for their thoughtful and insightful comments regarding our article, “Tuberculous Synovitis of the Elbow Presenting with Multiple Rice Bodies: A Rare Case Report.” We appreciate the interest shown in our work and the emphasis on the radiological “ice cream scoop” sign.

We agree that the characteristic proximal ulnar erosion described by Agarwal et al. represents an important radiographic feature in advanced elbow tuberculosis. The observation that a similar appearance may be present in adult cases, as highlighted by the author, is indeed valuable and adds to the existing understanding of disease patterns across age groups.

In our case, although osteolytic involvement of the proximal ulna was evident, the primary focus of our report was on the rare presentation with multiple rice bodies and the clinical management aspects. We acknowledge that explicit mention of the “ice cream scoop” sign could have further enriched the radiological discussion and aided readers in recognizing this imaging pattern.

We concur that this sign may not be confined to pediatric populations and can be encountered in advanced-stage disease in adults, as in our case. The author’s observation reinforces the importance of correlating radiographic findings with disease staging and clinical context.

We thank the author for bringing attention to this relevant radiological feature and contributing to a more comprehensive understanding of elbow tuberculosis.

Sincerely,

Dr. P. Ravisankar (Corresponding author)

Department of General Surgery, Division of Surgical Oncology,

Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India,

E-mail: ravisankarpichaia@gmail.com