Overview
Subcutaneous rheumatoid nodules are firm, painless lumps that can develop under the skin, most commonly over pressure points like elbows, knees, and fingers 1. They are a recognized manifestation of rheumatoid arthritis (RA) 1.Diagnosis
Diagnosis is typically made clinically based on the presence of characteristic nodules in patients with rheumatoid arthritis 1.
Histopathological examination of a nodule biopsy can confirm the diagnosis, showing characteristic features of rheumatoid granulomas 1.Management
Management is primarily directed at controlling the underlying rheumatoid arthritis 1.
For symptomatic or cosmetically concerning nodules, surgical excision can be considered 1.
Treatment of underlying rheumatoid arthritis with disease-modifying antirheumatic drugs (DMARDs) is the mainstay of management 1.Key Recommendations
Management of subcutaneous rheumatoid nodules should focus on controlling the underlying rheumatoid arthritis 1. (Evidence: Expert opinion)
Surgical excision may be considered for nodules that are symptomatic or cause cosmetic concern 1. (Evidence: Expert opinion)References
1 MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Mayo JR et al.. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017. Radiology 2017. link