Lymphoedema of the limbs as an extra-articular feature of rheumatoid arthritis

Seven patients with lymphoedema of the hands and arms, an unusual extra-articular feature of rheumatoid arthritis, are described. In all cases the lymphoedema persisted throughout follow up--in one case for more than five years--and was resistant to treatment with slow acting drugs, steroids, or cytotoxic agents. There was no correlation with severity of disease. It is concluded that the lymphoedema in these patients may be associated with reduced numbers of lymphatic vessels; increased capillary permeability or abnormal fibrinolysis may also be contributory factors. Conservative management of such patients is recommended.