Health Questions and Answers

Question: What are rheumatoid nodules? Where are they found?

Answer:

The classic rheumatoid nodule has a central area of necrosis surrounded by a rim of palisading fibroblasts that, in turn, is surrounded by a collagenous capsule with perivascular collections of chronic inflammatory cells. Rheumatoid nodules occur in 20-35% of patients with RA and can be found at the elbow, wrist, soles, Achilles tendon, head, or sacrum. RF is usually present. Accelerated nodule formation has been described in patients receiving methotrexate treatment for RA, even when methotrexate shows efficacy at calming the arthritis and the patient has had no previous nodule formation. Nodulosis goes away when methotrexate is discontinued.

Reference: Koopman WJ (ed): Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed. Philadelphia, Lippincott Williams & Wilkins, 2005

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