The subcutaneous rheumatoid nodule

The subcutaneous rheumatoid nodule is a common and diagnostically significant finding in rheumatoid arthritis. The presence of these extra-articular lesions correlates with the extent of joint involvement and they are an index of disease severity. The nodules themselves may give rise to clinical problems and the indications for surgical treatment include erosion and infection, peripheral neuropathy or pain from pressure, and limitation of motion because of the location of the lesion. Less frequently, rheumatoid nodules present in patients with rheumatoid nodulosis, a variant of rheumatoid disease where the nodules themselves are the primary manifestation of the disease and surgical treatment is highly useful. While subcutaneous nodules are very characteristic of rheumatoid arthritis and its variants, they are not quite pathognomonic. Rarely, they are found in the absence of rheumatoid disease, especially in lupus erythematosus and in healthy children.