What Is A Rheumatoid Nodule?

Lumps Can Be Bumps, But Some Are A Sign Of Rheumatoid Arthritis...

In This Article –

  • What is a rheumatoid nodule?
  • Are they painful?
  • What size an shape are they?
  • What parts of the body do they affect?
  • Who is at most risk?
  • Prevention of rheumatoid nodules
  • Treatment of rheumatoid nodules
  • Are they dangerous?

Recognising a rheumatoid nodule is essential in treating one and realising (if you haven’t already had the diagnosis), that you need to see a doctor urgently as you may have rheumatoid arthritis.

In either case, you could benefit from knowing what is a rheumatoid nodule…

What Is A Rheumatoid Nodule?

Rheumatoid nodules are a symptom that is unique to sufferers of rheumatoid arthritis. They are firm lumps that develop under your skin, typically near to joints that have been affected by the autoimmune disease. They will not bleed or ‘burst’ in the way that common pimples or boils might do.

Rheumatoid Nodules are actually lumps of inflamed tissue that form without a guaranteed reason and affect approximately 20-25% of rheumatoid arthritis sufferers.

Even doctors do not actually know why they form – genetics may play a part but so does poor management of your Rheumatoid arthritis.

They are not contagious in any way.

Typically, although they are lumps of inflammatory tissue, they actually behave differently to the nodules found attacking your joints. This makes them even harder to treat because specialist drugs aimed at controlling your Rheumatoid Arthritis wont have quite the same effect on these nodules.


Are They Painful?

As a general rule, rheumatoid nodules are not painful and are more of an inconvenience than anything else. However, they can become painful if they occur in sensitive areas of the body that rub frequently or areas that pull the skin tight and cause discomfort.

One example of this is when they form in the eyelids.

What Size And Shape Are Rheumatoid Nodules?

Rheumatoid nodules come in all shapes and sizes. They can very in size from the size of a pea to something resembling a large walnut or tangerine. Very often they will be ‘sort of rounded’ in shape, but again there is no reason for this and they can be oblong or any other shape really.

Having formed, some rheumatoid nodules may grow larger over time, whilst some will disappear. Some will be individual lumps on their own, while others may form in groups – there really is no rule as to why or how these lumps appear. When the nodules form in groups it is known as ‘Accelerated Nodulosis’ and typically occurs on the backs of your hands. There is also a link with groups of nodules forming to people that are undergoing methotrexate therapy.

Where Do They Affect?

The most typical place for nodules to occur is around or near to joints affected by rheumatoid arthritis, such as hands, feet, arms or elbows. However, they have been known to develop on occasions in many other places – frequently occurring on sufferers heels, but also sometimes on their eyelids or even internally in their lungs.

There is no known reason why they appear in different places, and sadly little research has been done in to finding out.

Who Is At Risk – What Causes Nodules?

Not everybody with rheumatoid arthritis suffers with rheumatoid nodules – typically around 20 to 25% of them do, but they can often be seen as a sign of difficult or poor arthritis management. Science has isolated a group of antibodies in the blood called ‘Rheumatoid Factor’. They are not found in the blood of everyone that suffers with rheumatoid arthritis – but they do seem to have a direct link with the patients most likely to suffer with rheumatoid nodules. An estimated 40% of individuals testing positive for rheumatoid factor going on to develop nodules.

People who smoke are much more predisposed to developing the nodules as are those people in the most developed stages of the disease.

Rheumatoid nodules are also much more likely to develop near a joint that has been hurt by cutting, bruising or grazing (suffered a ‘trauma’)

Individuals already prone to developing some of the ‘extra articular’ symptoms of rheumatoid arthritis (meaning symptoms outside of the joint), such as lung disease or inflammation of the blood vessels, are also in the high category of those getting nodules. In rare cases, these nodules may even develop in the lungs, although again you would not know this without a CT scan.

Finally, it has also been observed that bedridden patients have a much higher predisposition to suffering with rheumatoid nodules – on many of the common pressure points. This can even include occasionally forming on the back of the patients head – suggesting their formation is linked to repeated pressure.

About Us

‘Rheumatoid nodules are a sad fact of life for many rheumatoid arthritis sufferers, but if managed carefully they dont need to restrict your life at all.’

Prevention Of Rheumatoid Nodules

Much the same as with rheumatoid arthritis in general, the best known form of prevention of nodules is to manage your disease as effectively as possible.

This means following all the general guidance, giving up smoking, taking regular exercise and giving your body the best chance of delaying the slide in to late-stage rheumatoid arthritis.

Treatment Of Rheumatoid Nodules

According to some research centres, some biological therapies have seemingly been able to reduce the frequency of their formation.

Disease Modifying AntiRheumatic Drugs (DMARDs) have also been found sometimes to reduce the appearance of nodules.

Most frequently though, it comes down to a clinical decision as to how bothersome they really are – if their position makes them likely to suffer repeated cutting/ grazing (which leaves you prone to infections), then they can be removed surgically.

This isn’t a first choice, because frequently they will return very nearby if not in the same exact spot. However, it is one option, as is a steroid injection with the aim of reducing the size of the nodules.

Similarly, if the nodules occur on the bottom of your feet, then it may affect your balance or general mobility in which case removal becomes the best choice.

Neither option is going to ‘cure’ the nodules or get rid of them entirely, but if you are suffering with rheumatoid arthritis it is essential to try and avoid infections, that are likely if you are constantly catching and grazing a rheumatoid nodule.

Ultimately, most treatment protocols follow the line of controlling the underlying disease (rheumatoid arthritis) because this is the best known method of preventing the symptom of rheumatoid nodules.

Are they Dangerous?

Rheumaotid nodules are only really dangerous if they suffer trauma (cuts/ grazing) that leads to them becoming infected. Your body is so busy attacking you that it struggles to fight the infection properly as well.

Similarly, on rare occasions rheumatoid nodules may form on the internal organs of the body such as the lungs, heart or liver etc. In essence they are unlikely to cause you direct harm being there, but their mere presence may alter your bodies’ balance causing more problems in the longer term.

It has however been proven that someone with rheumatoid nodules is more at risk of also developing ‘vasculitis’ – inflamed blood vessels that can in some case be life-threatening and certainly very painful.

It is likely therefore that regular monitoring of the nodules with your doctor is not a bad idea.

The Final Word – Should You Worry About Rheumatoid Nodules?

Hopefully we have answered the question above ‘What Is A Rheumatoid Nodule’. From this you will have ascertained that on their own, they represent one of the more harmless symptoms of Rheumatoid Arthritis.

They only really represent a problem when they appear in awkward positions on your body, such as areas where friction might cause you pain (the eyes) or they might get repeatedly grazed or cut leading to increased risk of infection.

Where they are relatively harmless, such as on the back of your hands, most doctors will want to leave them alone. Partly because there is no guarantee they wont return and also because any procedure carries a small chance of infection.

And given that they are not dangerous in isolation, doctors are more worried about your rheumatoid arthritis.

There is no obvious treatment with antibiotics and a steroid injection is only likely to reduce the size of the rheumatoid nodule – not get rid of it completely.

So should you worry about them? That is one question we can’t answer – you probably shouldn’t but everyone copes with rheumatoid arthritis differently. They are an unfortunate symptom, but are unlikely to stop you doing anything in life, so for that reason we would propose ‘no’.

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