Rheumatoid nodulosis. A relatively benign rheumatoid variant

Area of Science:

• Rheumatology
• Immunology

Background:

• Subcutaneous nodules and rheumatoid factor (RF) are diagnostic criteria for rheumatoid disease, correlating with severity.
• These features are typically associated with significant arthritis and systemic disease.

Observation:

• Studied four patients with high RF titers, extensive nodulosis (elbows, hands, feet, tendons), and large subchondral bone cysts.
• Observed minimal active arthritis and no systemic disease in these patients.
• Noted misdiagnoses of gout or xanthoma in three patients.

Findings:

• Patients presented with nodulosis, bone cysts, and elevated RF with little active arthritis.
• Radiographs revealed large subchondral bone cysts without cortical erosion.
• Findings align with previous reports of similar cases.

Implications:

• Suggests a relatively benign variant of rheumatoid disease characterized by nodulosis, bone cysts, and elevated RF.
• Highlights the importance of recognizing this variant to avoid misdiagnosis and ensure appropriate management.
• Contributes to understanding the spectrum of rheumatoid disease presentation.