As part of the disease process, firm, non-tender, subcutaneous nodules develop in about 25% of rheumatoid arthritis patients. Rheumatoid nodules are typically found at pressure points. Common sites include the elbow, back of the forearm, and metacarpophalangeal joints (knuckles). They usually develop when rheumatoid arthritis is active. Rheumatoid nodules are commonly associated with joint deformity and serious extra-articular manifestations of rheumatoid arthritis, which may include involvement of the lungs, eyes, and blood vessels. Rheumatoid nodules may vary in size during the course of the disease process.
Rheumatoid nodules may be associated with complications, including:
- limited joint mobility
- fistula formation
Surgical removal is an option, but nodules tend to recur in as little as a few months when they are present over an area of repeated trauma. Intranodular steroid injections may reduce the size of a nodule.
Photos of Actual Rheumatoid Nodules
Arthritis Hand Photo Gallery
Hand damage and deformity caused by arthritis can include nodules, swelling, stiffness, ulnar drift, contractures, and other problems.
Rheumatoid Nodule of the Elbow
Photo of rheumatoid nodule of the elbow, from Loyola University Chicago.
Multiple Rheumatoid Nodules on Fingers
Photo of multiple nodules on several fingers of one hand, from Dermnet.
General and Specific Cutaneous Manifestations of RA, from New Zealand Dermatological Society
Three photos of rheumatoid nodules.
Interview with Raymond Federman, M.D. (rheumatologist)
Case rounds. Case report #6 by Andrea Marx, M.D., The Johns Hopkins University.