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About 20% of people with rheumatoid arthritis develop rheumatoid nodules, which are linked to more severe erosive disease in those patients. [2] The nodules are more common in men, typically manifest in the fifth decade of life, and are primarily found on extensor surfaces like the backs of the fingers and elbows, though they can occur anywhere.
These nodules occur almost exclusively in association with rheumatoid arthritis. Very rarely do rheumatoid nodules occur as rheumatoid nodulosis (multiple nodules on the hands or other areas) in the absence of rheumatoid arthritis. Rheumatoid nodules can also appear in areas of the body other than the skin.
Boutonniere deformity is a deformed position of the fingers or toes, in which the joint nearest the knuckle (the proximal interphalangeal joint, or PIP) is permanently bent toward the palm while the farthest joint (the distal interphalangeal joint, or DIP) is bent back away (PIP flexion with DIP hyperextension).
Caplan syndrome presents with cough and shortness of breath in conjunction with features of rheumatoid arthritis, such as painful joints and morning stiffness. Examination should reveal tender, swollen metacarpophalangeal joints and rheumatoid nodules; auscultation of the chest may reveal diffuse crackles that do not disappear on coughing or taking a deep breath.
Nodules in skin include dermatofibroma [5] and pyogenic granuloma. [6] Nodules may form on tendons and muscles in response to injury, [ 7 ] and are frequently found on vocal cords . [ 8 ] They may occur in organs such as the lung , [ 9 ] or thyroid , [ 10 ] or be a sign in other medical conditions such as rheumatoid arthritis .
People with severe involvement often show lumps on the back of their finger joints (called "Garrod's pads", "knuckle pads", or "dorsal Dupuytren nodules"), and lumps in the arch of the feet (plantar fibromatosis or Ledderhose disease). [17] In severe cases, the area where the palm meets the wrist may develop lumps.
1954, rheumatoid lung nodules were found in patients with RA who were not exposed to coal dust and without pneumoconiosis. 1955 there was a short case series of about 10 patients with RA whose autopsies showed that the pleural disease was much higher in rheumatoid patients than in the general population, and much higher than what they had ...
Rheumatoid neutrophilic dermatitis occurs more frequently in patients with severe, persistent seropositive arthritis; it presents clinically as erythematous papules, nodules, plaques, or lesions resembling urticaria without any accompanying symptoms. [3] [4] [5] Less common conditions include annular lesions, blisters, ulcers, and vesicles.