Images (5)
Rheumatic nodulesM06.30
Synonym(s)
nodules rheumatici; Rheumatoid nodules
DefinitionThis section has been translated automatically.
Nodosus nodules and nodules belonging to the so-called rheumatism nodosus, which occur in 20% of patients with chronic polyarthritis (rheumatoid arthritis), mostly in severe forms, but occasionally without joint symptoms.
LocalizationThis section has been translated automatically.
Especially the ulnar area, elbows, hands, back of fingers, retroauricular region (also above the ears) are affected.
Clinical featuresThis section has been translated automatically.
Indolent, skin-coloured, raised, hard, subcutaneous or in the soft tissues, up to hazelnut-sized, possibly ulcerated nodules.
LaboratoryThis section has been translated automatically.
Often positive rheumatoid factors or positive antinuclear factors.
HistologyThis section has been translated automatically.
In the deep dermis and the adjacent subcutaneous fatty tissue, map-like areas with homogeneous, eosinophilic degeneration of the collagenous connective tissue (fibrinoid necrosis), grouped nuclear remains, occasionally also calcareous material as well as palisade-like arranged histiocytes and giant cells surrounding the fibrinoid necrosis are impressive.
Differential diagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
Treatment of the underlying disease, possibly excision or glucocorticoid crystal suspension intrafocally with triamcinolone acetonide (e.g. Volon A 1:3 diluted with local anaesthetics, e.g. scandicain).
Progression/forecastThis section has been translated automatically.
Possible perforation in case of a longer period.