Living With Rheumatoid Nodules

Definition

1. Rheumatoid nodules, firm lumps formed out of soft tissue, appear under the skin, growing close to arthritic joints or in pressure point areas such as the hands, fingers, knuckles, elbows, heels and wrists. These nodules are generally painless and range in size from that of a small pea to a walnut. Nodules sometimes form in the heart, lungs or other internal organs.

   Causes and Complications

2. Rheumatoid nodules that form beside or within tendons often do so as a response to pressure and friction caused by rheumatoid arthritis (RA) in the joints. Nodules are usually found in patients who have been suffering from RA for quite some time. Cigarette smoking in patients who have RA increases the chance that nodules will form. Methotrexate, a medication used to manage the symptoms of RA, has been found to increase chances that nodules will form.
   
   Although they are often painless, rheumatoid nodules can sometimes put pressure on nerves or limit the movement of joints. In the feet, nodules can cause problems with gait and balance and make it difficult to wear shoes. When the nodules appear in the heart or the lungs, they can cause dysfunction or serious complications. Nodules in the lungs can lead to a collapsed lung, pneumonia or pleural effusion, which is an accumulation of fluid between the tissue lining the lungs and chest cavity.

   Treament Options

3. In most cases, treatment of rheumatoid nodules is not necessary; as they are generally not painful and do not usually interfere with daily life. However, disease-modifying antirheumatic drugs, or DMARDs, are prescribed to help reduce the size of the nodules. Injections of glucocorticoids, a type of steroid, at the site can sometimes also help shrink nodules. Should the nodule be painful, become infected or cause other health problems, surgery may be required. It is common for the nodule to form again after being surgically removed.