| Rheumatoid nodules are soft tissue lumps that occur | | | | With increasing severity of disease, the nodules may |
| in 20-30% of rheumatoid arthritis (RA) patients. They | | | | increase in size and in number. |
| may be found almost anywhere on the body, but are | | | | Complications of rheumatoid nodules include a number |
| most often seen in areas where there are bony | | | | of problems such as:o increased pain due to pressure |
| prominences. These include pressure points such as | | | | phenomenao limited joint mobility due to size and |
| the elbow, back of the forearm, and knuckles of the | | | | location of the noduleso nerve damage due to |
| hand. Sometimes they may occur on the back of the | | | | location of noduleso ulceration of the nodule leading |
| head or Achilles tendons. | | | | to infectiono fistulas (draining channels) that connect |
| Nodules usually occur in chronic active cases of | | | | the inside of the nodule to the skin surface. Fistulas |
| rheumatoid arthritis, and are commonly associated | | | | can easily become infected.o infection |
| with more severe joint deformity and serious disease. | | | | Surgical removal is an option. Patients with rheumatoid |
| People with rheumatoid nodules often have very high | | | | nodules tend to heal more slowly than people without |
| levels of rheumatoid factor in the blood. | | | | the disease. As a result, removal of nodules needs to |
| At a microscopic level, these nodules often contain | | | | be done carefully and the surgical wound monitored |
| the same types of cellular infiltrates as seen in the | | | | carefully for dehiscence (reopening). In particular, |
| joints. | | | | patients who are taking corticosteroids may be the |
| Patients with very serious RA may have problems in | | | | ones who need to be monitored most carefully. |
| other organ systems. These are referred to as | | | | Nodules may also reoccur, particularly if they are |
| extra-articular (outside the joint) manifestations. | | | | located in areas where there is repetitive pressure or |
| These extra-articular areas include the lungs, eyes, | | | | trauma. |
| skin, heart, brain, and blood vessels. Nodules may | | | | Steroid injections into the nodule may reduce the size |
| vary in size during the course of the disease process. | | | | of the nodule. |