Atypical Rheumatoid Nodules: A Possible Precursor to a Rheumatoid Variant in a Rheumatoid-Factor-Negative Patient. Case Report

Abstract

Subcutaneous nodules occur in approximately 20-25% of rheumatoid factor (RF)-positive rheumatoid patients. In this paper, we present a unique case of a 47-year-old healthy RF-negative woman with a 3-year history of necrobiotic nodules over the dorsum of her hands, extensor forearms, and lower extremities. This may represent an atypical presentation or a new rheumatoid variant.

Soft tissue swellings in the foot: Rheumatoid nodulosis

“…The development of subchondral cysts is frequently seen in small bones. A number of authors state that, unlike rheumatoid disease, rheumatoid nodulosis cystic lesions do not appear to lead to erosive arthritis [12][13][14]. The use of ultrasound in this case demonstrated erosions not identified on X-ray.…”

Approach to Fine Needle Aspiration of Giant Cell-rich Tumors of Soft Tissue

“…Rheumatoid nodules are firm, often fixed nodules that occur most frequently in the subcutaneous tissue at sites of pressure or trauma, usually on the extensor surfaces of extremities, in a subset of patients with rheumatoid arthritis. Afflicted patients typically have longstanding, severe disease and high circulating rheumatoid factor, although these nodules have also been reported in patients without arthritis 6,7…”

“…Afflicted patients typically have longstanding, severe disease and high circulating rheumatoid factor, although these nodules have also been reported in patients without arthritis. 6,7 Rheumatoid nodules contain necrobiotic debris that triggers a granulomatous reaction. Cytologically, smears are usually hypocellular and contain amorphous debris that appears pale blue on Romanowsky stain and pale purple on Giemsa stain, associated with chronic inflammation including lymphocytes, plasma cells, and histiocytes.…”