Lower limb nodules IMAGES IN MEDICINEA 45-year-old Chinese woman with no medical history or regular medications presented with painful nodules on her left shin that progressed to involve her right shin, thighs and lower back over a period of 3 months. There was associated lower limb joints stiffness. Systemic review revealed constitutional symptoms of loss of appetite, night sweats and amenorrhea of 3 months' duration. She also had unintentional weight loss of 7kg over the preceding 2 months. Examination demonstrated multiple indurated erythematous to violaceous plaques and nodules over bilateral thighs, calves and shins (Fig. 1), associated with bilateral lower limb pitting oedema up to mid-thigh.