What Are Rheumatoid Nodules?

Rheumatoid nodules are firm lumps under the skin. They tend to form close to joints in people affected by rheumatoid arthritis.

How big are they? These bumps can be as large as a walnut or as small as a pea.

What do they feel like? Some are doughy. Others are firm.

Do they hurt? Not unless there’s an underlying inflammation or sore, or they’re close to a nerve.

Do they move around? 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.

ra hand noduleWhere do they form? Most often, you’ll find them in spots that get bumped a lot or where there’s a lot of pressure.

The most common locations for rheumatoid nodules are:

  • Handsra elbow nodules
  • Fingers
  • Knuckles
  • Elbows

 

Where Else Can They Show Up?

As you live with RA for a while, you can be more likely to have nodules. You might get them in your:

  • ra lung nodulesVocal cords: If they form here, you might get hoarse.
  • Lungs, heart, and other organs: When they show up in these parts of your body, nodules can affect how they work.

If you’re confined to a bed, you might get them on places where your body touches the mattress:

 

Should You Worry About Nodules?

No. Rheumatoid nodules don’t give most people with RA any problems. It’s OK to leave them alone f they aren’t causing trouble. But if they hurt or make it harder to do daily activities because they put pressure on nerves, limit movement, or are in sensitive locations, talk to your doctor.

What Causes Rheumatoid Nodules?

Not everyone with RA gets them. Doctors believe these things can make you more likely to get nodules:

  • They usually show up in people with more severe RA.
  • Nearly all cases are in people who have substances called rheumatoid factor and anti-cyclic citrullinated peptide antibodies in their blood. These are linked to inflammation.
  • One study found that cigarette smoking increases nodules in people with RA.
  • They may be more likely if your RA is extra-articular, meaning it affects body parts other than your joints. The most common are lungs and blood vessels. (Your doctor will call this vasculitis.)

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What Is Accelerated Nodulosis?

Methotrexate (a common treatment for RA) can lead to this condition, which causes small nodules to form quickly around your finger joints. If that happens, your doctor will often switch you to another medicine.

How to Get Rid of Nodules

DMARDs (disease-modifying antirheumatic drugs): Sometimes these common RA medications can cut the size of rheumatoid nodules. One that seems to work well is rituximab.

Steroids: Some people get steroid shots directly into the nodules to shrink them.

Surgery: If the lumps become infected or cause severe symptoms, like the inability to use the joint, you may need surgery to remove them. Just know that nodules often come back in the same spot after removal.

WebMD Medical Reference Reviewed by Louise Chang, MD on April 26, 2018

Sources

SOURCES:

American Osteopathic College of Dermatology: “Rheumatoid Nodules.”

National Rheumatoid Arthritis Society: “Rheumatoid nodules.”

American College of Rheumatology: "Rheumatoid Arthritis."

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

CDC: "Rheumatoid Arthritis."

American Association for Clinical Chemistry: "Rheumatoid Factor."

Garcia-Patos V. Semin Cutan Med Surg, June 2007.

Ziff, M. Arthritis Rheum, 1990.

Kaye B.R. American Journal of Medicine, 1984.

Sayah, A. Journal of the American Academy of Dermatology, 2005.

Nyhall-Wahlin, B.M. Ann Rheum Dis, 2006.

Ylitalo, R. Clin Otolaryngol Allied Sci, 2003.

McGrath, M.H, Hand Clin, 1989.

Merrill, J. Arthritis and Rheumatism, July 1997.

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