A subcutaneous tumour in a patient with rheumatoid arthritis

Abstract

A 79-year-old Caucasian woman with rheumatoid arthritis (RA) for 27 years presented with a swelling on her left wrist. Both pain and a tingling sensation in the radial four fingers could be elicited by applying light pressure on the swelling. The patient was uncertain as to the actual onset of this swelling and had not complained, as it resembled many of the swellings of the hand region she had previously experienced. Primarily, an organised tenosynovitis was suspected with a presumed pressure on the median nerve, and a puncture was considered. Ultrasonography diagnosed a large hypoechoic mass. This is not unusual with longstanding inflammatory changes, which may contain elements of connective tissue. Using the Doppler function it turned out to be highly vascularised. The tumour could not be removed, but histology revealed a diagnosis of schwannoma.

Symptom Complexes at the Earliest Phases of Rheumatoid Arthritis: A Synthesis of the Qualitative Literature

“…We note that symptoms occasionally reported by patients with established RA (e.g., numbness 44 , tingling 45 , jaw pain 46 , and symptoms of restless legs and leg cramps [ 47 , 48 ]) were not found in the literature included in this review, which focused on disease onset, and the presence of these should be explored in further qualitative work. A systematic review of the symptoms of established RA has yet to be undertaken; however, it is important to consider the symptoms identified in the present review in relation to the symptoms that are recognized to be associated with established RA.…”