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Rheumatoid nodules can vary in size from 2 mm to 5 cm and are usually rather firm to the touch. Quite often they are associated with synovial pockets or bursae. About 5% of people with rheumatoid arthritis have such nodules within two years of disease onset, and the cumulative prevalence is about 20–30%. [4]
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.
Heberden's nodes are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes). [1] They are a sign of osteoarthritis and are caused by formation of osteophytes (calcific spurs) of the articular (joint) cartilage in response to repeated trauma at the joint.
A Bouchard's node on the proximal interphalangeal joint of the index finger of a 64 year old man. Bouchard's nodes are comparable in presentation to Heberden's nodes, which are similar osteoarthritic growths on the distal interphalangeal joints, [1] but are significantly less common.
Jaccoud arthropathy (JA), is a chronic non-erosive reversible joint disorder that may occur after repeated bouts of arthritis. [1] [2] It is caused by inflammation of the joint capsule and subsequent fibrotic retraction, causing ulnar deviation of the fingers, through metacarpophalangeal joint (MCP) subluxation, [1] [3] primarily of the ring and little-finger. [3]
Erythema nodosum (EN) is an inflammatory condition characterized by inflammation of subcutaneous fat tissue, resulting in painful red/blue lumps or nodules that are usually seen symmetrically on both shins, on the thighs, arms, and elsewhere. [1] It can be caused by a variety of conditions but 20 to 50% of cases are idiopathic.
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. [11]
Histopathology of localized TGCT arising in hand finger. H&E stain. Localized TGCT is sometimes referred to as localized pigmented villonodular synovitis (L-PVNS), giant cell tumor of the tendon sheath (GCT-TS), nodular tenosynovitis, localized nodular tenosynovitis, and L-TGCT. [2]: 1 [3]: 100 The localized form of TGCT is more common.