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Updated: Jul 28, 2025

Evaluating the Function of the Foot Core System in the Elderly
Published on: March 11, 2022
Rheumatoid nodule presenting as an indeterminate soft tissue mass in the sole of the foot
Ravi Patel1,2, Raghav Nand3, Dakshinamurthy Sunderamoorthy3
1Department of Trauma and Orthopaedics, The Princess Royal Hospital, Telford, UK.
Abstract:
A 64-year-old lady with a background of rheumatoid arthritis presented to the foot and ankle clinic with lump underneath the sole of her foot causing significant discomfort. Examination revealed she had a swelling of the first and the second metatarsophalangeal joints. Magnetic resonance imaging revealed abnormal soft tissue thickening between the second and the third metatarsal and a single large encapsulating indeterminate soft tissue mass with a peripheral inflammatory rim. The appearance was suggestive of a malignant sarcoma rather than a rheumatoid nodule or rheumatoid tenosynovitis. The patient was referred to the regional sarcoma unit where the scans were reviewed, and a sarcoma was ruled out. The patient then underwent excision of the indeterminate soft tissue mass. Histology revealed granulomatous infiltration suggestive of a rheumatoid nodule. This has not been described previously in the literature.
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