Understand rheumatoid arthritis nodules: causes, symptoms and treatment options. More information about the treatment of this disease.

Understanding Rheumatoid Arthritis Nodules: Causes, Symptoms, and Treatment Options. More information about the treatment of this disease.

Rheumatoid arthritis (AR) is a chronic autoimmune disease characterized by the inflammation and swelling of the joints. One of the distinctive features of the AR is the formation of rheumatoid arthritis nodules, which are groups of abnormal cells that can develop in various parts of the body, but that are usually found near the joints affected by the disease. These nodules can be a size of a few millimeters to several centimeters and can cause discomfort, pain and functional deterioration.

Understand the nature of rheumatoid arthritis nodules:

  1. Composition: Rheumatoid arthritis nodules are composed of inflammatory tissue, mainly formed by immune cells, called macrophages
  2. Location: They are usually near the joints that are usually affected by the AR, such as hands, fingers, elbows and feet. However, they can also develop in other areas of the body, such as lungs, heart and vocal cords.
  3. Training: The exact mechanism that underlies the development of these nodules is not yet entirely known by medical researchers. However, it is believed that they arise due to the abnormal immune response characteristic of the AR. Factors such as genetic predisposition and environmental triggers also influence.
Characteristic Description
Size Rheumatoid arthritis nodules can vary greatly in size, from small nodules the size of a pea to larger and more striking.
Texture These nodules tend to be firm to the touch and sometimes they may seem gummy or hard.
Pain Although rheumatoid arthritis nodules are usually painless, they can cause discomfort if they develop near a joint or exert pressure on surrounding tissues.

“Rheumatoid arthritis nodules are not exclusive to patients with advanced or long evolution rheumatoid arthritis; they may also appear at the beginning of the progression of the disease. However, their prevalence tends to increase over time, especially in individuals with individuals withB poorly controlled. “

“Although rheumatoid arthritis nodules are usually harmless, their presence should not be overlooked. In some cases, these nodules can be inflamed, infected or compressed vital structures, giving rise to complications. It is important that people with ar regularly monitor thedevelopment and growth of the nodules and go to the doctor if they are worried about something. “

Rheumatoid Arthritis Nodules: Causes, Symptoms, and Treatment

The exact cause of rheumatoid arthritis nodules is not fully known. However, researchers believe they can develop as a result of an abnormal immune response in people with rheumatoid arthritis. It is believed that immune cells called macrophages release inflammatory substances that cause the formation of these nodules. In addition, factors such as genetic predisposition, hormonal changes and environmental triggers can contribute to the development of rheumatoid arthritis nodules.


  • Abnormal immune response
  • Macrophages that release inflammatory substances
  • Genetic predisposition
  • Hormonal changes
  • Unleashed environmental factors


Rheumatoid arthritis nodules are usually painless and do not cause important discomfort. However, in some cases they can become sensitive, painful or inflamed, especially if they are located near an articulation. These nodules can vary in size, from a few millimeters to several centimeters. They are firm to touch and can be mobile or be fixed under the skin.


There is no specific treatment for rheumatoid arthritis nodules. In most cases, treatment focuses on controlling underlying rheumatoid arthritis. To control inflammation and relieve symptoms, medications such as no n-steroidal ant i-inflammatories (NSAIDs), antirreumatic drugs modifiers of the disease (FAME) and biological agents can be prescribed. In situations in which the nodules become painful or interfere with joint function, surgical removal can be considered.

What are Rheumatoid Arthritis Nodules?

The cause of rheumatoid arthritis nodules is not known exactly. However, it is believed that they arise as a result of the abnormal immune response of the AR. In rheumatoid arthritis, the immune system attacks by mistake the body’s own tissues, including the coating of the joints, which causes inflammation. This inflammation can trigger the formation of nodules, composed of immune cells, fibroblasts and collagen fibers.

Important information:

  • Rheumatoid arthritis nodules are frequently observed in people with a serious and long evolution.
  • They are more frequent in women than in men.
  • The nodules can vary in size and texture, from the size of a pea and soft to larger and more hard.
  • Although the nodules usually develop under the skin, they can also be formed in other organs, such as lungs or heart, although this is rare.

It is important to note that rheumatoid arthritis nodules are not always painful or annoying. However, they can cause discomfort if they develop in areas prone to friction or pressure, such as palms of the hands or soles of the feet. In some cases, the nodules can interfere with the operation of the joint or contribute to damage it even more. Therefore, people with AR that develop nodules should consult their doctor for adequate evaluation and treatment.

Although rheumatoid arthritis nodules are a characteristic feature of the AR, not all people with the disease develop them. Its presence does not necessarily indicate a more serious progression of the disease, but they can justify additional monitoring and treatment to guarantee optimal control of the symptoms and complications of the AR.

In general, rheumatoid arthritis nodules are small and firm packages that can develop in the skin or other organs of people with a serious and long evolution. Although they do not always cause functional pain or deterioration, they must be evaluated by a medical professional to determine the best way to treat them.

Causes and Risk Factors of Rheumatoid Arthritis Nodules

Although the exact cause of rheumatoid arthritis nodules is not yet known completely, researchers believe they are the result of an erroneous immune response of the organism. In people with rheumatoid arthritis, the immune system attacks by mistakes the coating of the joints, which causes inflammation and joint injuries. This chronic inflammation can contribute to the appearance of nodules, since immune cells and fibroblasts accumulate and form small compact masses in the affected tissues.

It is important to take it into account:

  • Rheumatoid arthritis nodules are more frequently observed in individuals with severe or long evolution rheumatoid arthritis.
  • The presence of the rheumatoid factor, an antibody present in the blood of many people with AR, is associated with an increased risk of developing nodules.
  • Smoking has been identified as an important risk factor for the development of rheumatoid arthritis nodules.
  • Women are more likely to develop these nodules than men.
  • The nodules tend to form in repeated pressure or irritation areas, such as joints and tendons.

There are other factors that can also contribute to the formation of rheumatoid arthritis nodules. Genetic predisposition plays a role, since certain genetic variations have been related to an increased risk of developing and its associated complications. In addition, the presence of other coexisting conditions, such as obesity and cardiovascular diseases, can exacerbate the development of nodules in individuals with rheumatoid arthritis.

Summary of risk causes and factors of rheumatoid arthritis nodules
Causes Risk factor’s
Chronic inflammation and immune response Severe or lon g-lasting rheumatoid arthritis
Presence of rheumatoid factor
Genetic predisposition Female sex
Repeated pressure or irritation zones
Coexisting conditions (obesity, cardiovascular diseases)

Recognizing Symptoms and Types of Rheumatoid Arthritis Nodules

Symptoms: Recognizing symptoms associated with rheumatoid arthritis nodules is crucial for early detection and timely treatment of the disease. Although the presence of nodules can be indicative of an underlying AR, not all people with AR develop. However, when they appear, their size can vary from small nodules similar to peas to more large and more prominent ones. In most cases, these nodules are painless, although they can cause discomfort if they press close structures. Although the nodules are a characteristic feature of the AR, it is important to point out that its absence does not exclude the diagnosis of the disease.

Types of Rheumatoid Arthritis Nodules:

Rheumatoid arthritis nodules can be classified into two main types: subcutaneous nodules and visceral nodules.

  1. Subcutaneous nodules: These nodules are the most commonly observed type and are usually found just below the skin, especially on bone prominences or areas under pressure or frequent trauma, such as the back of the fingers, elbows or knees. Subcutaneous nodules are usually small, firm and mobile, and are composed of inflamed tissue and immune cells.
  2. Visceral nodules: rarely, nodules can also develop internally, affecting organs such as lungs or heart. Visceral nodules are less frequent and require immediate medical attention due to their possible impact on the operation of the organs. These nodules can cause symptoms such as breathing difficulty, chest pain or palpitations, depending on their location and size.

Diagnostic Procedures for Rheumatoid Arthritis Nodules

A common and effective diagnostic procedure to identify RA nodules is physical examination. During this exam, the doctor will carefully feel the joints and surrounding areas to look for any abnormal nodules. RA nodules usually develop under the skin, usually over bony prominences, such as the elbows or fingers. These nodules are firm and immobile, and range in size from small, pea-like structures to large, noticeable lumps. The presence of these nodules, combined with other clinical characteristics of RA, can provide valuable evidence for the diagnosis.

  • Physical examination is a crucial diagnostic procedure to detect RA nodules.
  • During the examination, healthcare personnel feel the joints and surrounding areas.
  • RA nodules are firm, immobile, and usually develop on bony prominences.

It is important to note that RA nodules are not exclusive to RA patients and can also appear in other diseases, such as systemic lupus erythematosus (SLE) or gout. Therefore, additional diagnostic procedures may be necessary to confirm the diagnosis of RA and rule out other possible causes of nodules.

Another diagnostic procedure commonly used to evaluate RA nodules is imaging studies. X-rays, ultrasounds, or MRIs can help visualize the nodules and evaluate their location, size, and characteristics. Radiographs may show typical nodular calcifications and erosive changes in the bony structures surrounding the nodules. Ultrasound can provide real-time images to evaluate the composition of the nodules, such as the presence of fluid or signs of inflammation. MRI provides detailed cross-sectional images and can help evaluate the extent of joint involvement and the presence of nodules in deeper tissues.

  1. Imaging studies, such as x-rays, ultrasounds, or MRIs, are frequently used to evaluate RA nodules.
  2. X-rays may reveal calcifications and erosive changes around the nodules.
  3. Ultrasound provides real-time images and helps evaluate the composition of the nodules.
  4. MRI provides detailed cross-sectional images and helps evaluate deeper tissue involvement.
Diagnostic procedure Purpose
Physical exploration Detect the presence of RA nodules by palpating the joints and surrounding areas.
Imaging studies (x-rays, ultrasounds, MRI) To visualize, evaluate the location, size and characteristics of the nodules, as well as evaluate bone and tissue involvement.

Treatment Options for Rheumatoid Arthritis Nodules

With regard to the treatment of rheumatoid arthritis nodules, therapeutic options vary depending on individual symptoms and the general activity of the disease. The main objective of treatment is to reduce pain, swelling and inflammation, and improve joint function and quality of life in general. Below are some of the most used therapeutic approaches for rheumatoid arthritis nodules:

Medical Management:

  • No n-steroidal ant i-inflammatory drugs (NSAIDs): These medications, such as ibuprofen and naproxen, can help relieve pain and reduce inflammation associated with rheumatoid arthritis nodules.
  • Antirreumatic drugs modifiers of the disease (FAME): These drugs, which include methotrexate and sulfashalazine, are usually prescribed to control the underlying process of the disease and can also help reduce the formation and size of the nodules.
  • Corticosteroids: Corticosteroid injection directly into the nodules can temporarily relieve pain and inflammation. However, prolonged use of corticosteroids can have adverse effects.

Surgical Interventions:

In cases where rheumatoid arthritis nodules become very painful or restrict the movement of the joint, the possibility of performing surgical interventions can be considered. Surgical options may include:

  1. Nodule split: This procedure consists of surgical removal of nodules, which can relieve symptoms.
  2. Tendons release: If the nodules are causing inflammation and tendon constriction, the release of the affected tendons can improve joint function and reduce pain.
  3. Articular substitution: In advanced cases in which the nodules have caused important damage to the joints, joint substitution surgery may be necessary to restore joint function.

It is important that people with rheumatoid arthritis nodules collaborate closely with their health team to determine the most appropriate therapeutic approach. The treatment plan can include a combination of medicines, physiotherapy and lifestyle modifications to effectively control both nodules and underlying rheumatoid arthritis.

Managing and Preventing Rheumatoid Arthritis Nodules

1. Medication: The use of disease-modifying antirheumatic drugs (DMARDs) is a crucial component in the treatment and prevention of RA nodules. DMARDs help suppress the immune system, reducing inflammation and preventing nodule formation. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be prescribed to relieve pain and inflammation associated with the nodules. It is important to remember that medication should be taken as directed by a healthcare professional and that periodic follow-ups should be scheduled to monitor progress and adjust treatment if necessary.

  1. Lifestyle modifications: Some lifestyle changes can also help control and prevent the appearance of RA nodules. Regular exercise, such as low-impact activities and stretching, can help improve joint flexibility and reduce stiffness. Avoiding repetitive movements and overexertion can also prevent additional stress on the joints, which can contribute to nodule formation. Additionally, maintaining a healthy weight can relieve pressure on your joints and reduce your risk of developing nodules.
  2. Protect joints: Taking steps to protect joints from excessive pressure and trauma is crucial to managing and preventing RA nodules. This may include the use of assistive devices, such as braces or splints, to support and stabilize affected joints. Additionally, practicing proper body mechanics and ergonomics can help reduce joint stress during everyday activities. Avoiding activities that place excessive stress on the joints, such as prolonged kneeling or grasping, can also minimize the risk of nodule formation.
  3. Diet and nutrition: Although diet alone cannot cure RA or prevent nodules, maintaining a healthy, balanced diet can contribute to overall joint health. A diet rich in fruits, vegetables, whole grains, and lean proteins can provide essential nutrients and antioxidants that can help reduce inflammation. Omega-3 fatty acids, found in fatty fish and some nuts and seeds, have been shown to have anti-inflammatory properties and may be beneficial for people with RA. It is recommended that you consult a healthcare professional or registered dietitian for personalized dietary guidance.

Author of the article
Dr.Greenblatt M.
Dr.Greenblatt M.
Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont

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