What Are Rheumatoid Nodules?

Rheumatoid nodules are firm lumps under the skin. They form close to joints affected by rheumatoid arthritis. These bumps can be as large as a walnut or as small as a pea. Not everyone with RA gets them.

Some nodules can move. Others stay firmly in place because they're connected to tendons or other bands of tissue called fascia under the skin.

They often show up in:

  • Hands
  • Fingers
  • Knuckles
  • Elbows

They can form on the vocal cords, too, which causes hoarseness. You can also get them in your lungs, heart, and other organs, which can affect how these parts of your body work.

Nodules don’t give most people with RA any problems. But for some, they are painful and make it harder to do daily activities because they put pressure on nerves, limit movement, or are in sensitive locations. They are not usually removed unless they are causing problems. If that’s you, work with your doctor to treat them.

What Are the Causes of Rheumatoid Nodules?

They usually show up in people with severe RA. Nearly all cases are in people who have an immune system substance called “rheumatoid factor” in their blood.

Other things may also increase the risk for nodules. One study found that cigarette smoking increases nodules in people with RA. Methotrexate, a commonly used RA drug, has also been linked to rheumatoid nodules.

Are There Treatments?

Sometimes RA medicines called DMARDs (disease-modifying antirheumatic drugs) can reduce the size of rheumatoid nodules. But people who take methotrexate (which is a DMARD) may get more and bigger nodules. In that case, your doctor will often switch you to another medicine.

Some people get steroid shots to shrink nodules. If the lumps become infected or cause severe symptoms, you may need surgery to remove them.

WebMD Medical Reference Reviewed by David Zelman, MD on February 18, 2016

Sources

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American College of Rheumatology: "Rheumatoid Arthritis."

National Library of Medicine: "X-Plain Rheumatoid Arthritis."

CDC: "Rheumatoid Arthritis."

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