Sometimes in individuals with rheumatoid arthritis, subcutaneous nodules can develop. These tend to be firm and are not tender to touch, and develop on around a quarter of rheumatoid arthritis patients. They can vary in size and usually develop at pressure points such as the back of the forearm, the elbow, metacarpophalangeal joint and pressure points on the knees and feet. The nodules mainly occur in chronic cases of rheumatoid arthritis, and can be associated with joint deformity and extra- articular menifestations of the condition, where organs such as the lungs and eyes are affected.

Known as rheumatoid nodules, they can cause complications such as limited joint mobility, pain, ulceration, neuropathy and infection. Although they are not usually painful, they can cause problems if they are located in an area subject to a lot of use, such as hands or feet.
Rheumatoid nodules can be removed by surgery, but if they are found in an area of repeated use or trauma, they can return within a few months. Intranodular steroid injections can be effective in reducing the size of the nodule.

Osteoarthritis can cause a different type of nodule; enlargements of the last joints of the fingers. These are known as Heberden’s Nodules, and development can be affected by genetic factors.

The middle joints of the fingers may also be affected, known as Bouchard’s Nodules. The joint where the hand and wrist meet can also become enlarged, giving the hand a somewhat squared appearance.

Initially these ‘nodules’ are filled with a gel- like substance known as mucin, and can be painful or tender to touch. In time they may harden and become boney in texture.

They typically develop in middle age, and symptoms can include a redness of the joints, or swelling. This can be followed by numbness or loss of dexterity. Once the nodules are formed, the pain and initial swelling usually subsides, but can leave the fingers deformed.
Heberden’s and Bouchard’s nodules are more likely to develop in women.

Tags: Arthritis in hands, Arthritis Symptoms, Causes Of Arthritis, Hand Nodules, Types Of Arthritis

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