Rheumatoid nodulosis: a new case report

Soft tissue swellings in the foot: rheumatoid nodulosis

Background rheumatoid nodulosis is a rare disease characterised by multiple subcutaneous nodules, a high titre of rheumatoid factor, radiologically detectable cystic bone lesions, but with none or few of the systemic manifestations or joint activity of rheumatoid disease. Histopathologically, nodulosis is the same as the nodules found in rheumatoid arthritis. It is considered to be a benign variant of rheumatoid arthritis. A 69 year old male presents with multiple subcutaneous nodules on the feet. This case study highlights the benefits of ultrasound in establishing a correct diagnosis and management. Although rare, rheumatoid nodulosis is a consideration in the differential diagnoses of soft tissue swellings in the feet.

Rheumatoid nodules without arthritis

A 53-year-old man presented with firm, non-tender subcutaneous nodules overlying his hands and elbows. These had been progressive in number and size over 7 years. Rheumatoid factor was negative but a biopsy was consistent with rheumatoid nodules. He has never had any joint symptoms and remains otherwise asymptomatic. Examination is unremarkable except for the nodules described. We believe this man has rheumatoid nodules with no evidence of arthritis.