Large geodes in rheumatoid arthritis without joint destruction

Although subchondral geodes are a well-known radiological feature of rheumatoid arthritis (RA), large geodes are uncommon. Progressive bone damage with pathological fractures has been reported. We report the case of a 49-year-old man with seropositive RA in whom large, rapidly progressive geodes in the wrists, hands, and feet contrasted with the absence of joint destruction, good functional tolerance, and moderate abnormalities of markers for inflammation. The location and rapid progression of the cyst-like lesions in this patient were highly unusual.