Rheumatic Nodules

By | June 8, 2022

Rheumatism is a metabolic disease that can occur at any age. One of its accompaniments is rheumatoid nodules that form just under the skin. At first they are about the size of a pea, and over time they can become the size of a tennis ball. They are easy to feel, can be displaced and usually form in areas of the body that are subject to pressure.

What is a rheumatic nodule?

The technical term for rheumatoid nodules is “nodular” (nodular) foci of inflammation. They occur in about 20 percent of patients suffering from chronic rheumatism.¬†For about incontinence (urinary incontinence), please visit bittranslators.com.

It is not typical here that a severe progressive form of the disease is the underlying cause.

Terms such as Heberden knot or Bouchard knot are also considered synonyms. They can appear on joints as well as on internal organs. Rheumatoid nodules represent a pathological accumulation of collagen or connective tissue fibers.

If they form on the front joints of the fingers, then the technical term is Heberden knots. If they appear on the middle joints of the fingers, it is called Bouchard’s node.


The causes of rheumatism are not clearly understood. The fact is, however, that the knots are caused by inflammation of the synovial membrane. This can only happen if the body is not able to activate suitable defense mechanisms. The opposite is the case. The defenses are directed against the body’s own substances.

This causes the synovium to swell until it overgrows the cartilage in the joint. The synovia (joint fluid) can no longer or only partially fulfill its task and permanent damage occurs in the joint and the bones affected. The joints can stiffen to the point of complete inability to move.

Scientists name a number of risk factors that can cause rheumatism and, as a result, rheumatoid nodules. This includes the predisposition within the family. If parents or grandparents are ill, they can pass the disease on to their offspring. Smoking, improper diet and advanced age are also considered causes of rheumatoid nodules.

In some cases, an impact or crushing also causes the knots to form. There are studies that show that taking certain medications can also promote the formation of rheumatoid nodules.

Symptoms, Ailments & Signs

The first signs of rheumatic nodules appear suddenly as reddening of the skin, tenderness and warming of the affected joints. In other patients, the signs come on very slowly and there are hardly any symptoms. Typical symptoms are that the fine motor skills of the fingers decrease.

The strength is also reduced. Although those affected can grab it courageously, the object slips out of their hands involuntarily. Rheumatoid nodules can also develop in the internal organs such as the heart, lungs, liver, kidneys and bone marrow. In the lungs, they lead to scarring changes in the tissue.

The knots here are only a few millimeters thick and initially do not cause any discomfort. However, since they can form a breeding ground for pulmonary tuberculosis or carcinoma, regular monitoring by means of X-rays is essential for survival. Pericarditis can also be the result of rheumatoid nodules.

Diagnosis & course of disease

The nodes do not necessarily only appear in rheumatic diseases. It is therefore important to distinguish it from other clinical pictures. Diagnosis can be made through blood tests and X-rays. During the examination, the specialist first creates the anamnesis.

He wants to know if there are any rheumatic diseases in the family. This is followed by an external examination of the joints and the entire musculoskeletal system. When the blood is analyzed, inflammation levels and rheumatoid factors are determined. The determination of the anti-CCP value (antibodies against cyclic citrullinated proteins) is considered the most important innovation in the last ten years.

This is increased in patients with rheumatism in most cases. Antibodies help the body fight off harmful substances and protect it from diseases. In the case of autoimmune diseases such as rheumatism, however, the organism forms antibodies that are directed against its own body. Inflammation develops and over time leads to destruction of the joint capsule and cartilage. Rheumatoid nodules develop.

If these have formed on the internal organs, they are diagnosed by ultrasound, CT and autopsies. Depending on the extent of the nodes, if left untreated, they can lead to a life-threatening process. Although they are rare, they are considered to be a trigger for pericarditis and impaired lung function.


First and foremost, those affected with a rheumatic nodule suffer from skin problems. This causes severe reddening of the skin and in some cases itching. Scars can also occur, especially when the skin is scratched. Furthermore, those affected also suffer from significantly reduced fine motor skills and strength in their fingers.

This leads to restrictions in the everyday life of the patient, so that they are dependent on the help of other people. Rheumatoid nodules can also form on the internal organs and lead to tissue damage. The further course of the disease also depends heavily on the organ affected, so that a general prediction cannot usually be made.

Lung problems or inflammation of the pericardium can also occur as a result of the disease. Rheumatoid nodules are usually treated with medication. There are no particular complications. In serious cases, however, surgical removal of the nodes is necessary. Whether life expectancy will be reduced cannot generally be predicted.

When should you go to the doctor?

As a rule, rheumatoid nodules should always be treated by a doctor. This disease cannot usually be treated by self-help, and self-healing does not occur either. The person concerned is therefore always dependent on treatment by a doctor. A doctor must be consulted if the person concerned suffers from severely reddened skin and the reddening does not go away on its own. This can also lead to tightening of the skin, whereby the tightening itself is also associated with severe pain. The skin is warm and feels uncomfortable. The fine motor skills in the fingers can also decrease. If these symptoms occur, a doctor must be consulted in any case.

Rheumatoid nodules are usually treated by a dermatologist. However, since rheumatoid nodules also increase the risk of cancer, regular check-ups should be carried out in order to identify and treat tumors at an early stage.

Treatment & Therapy

Rheumatoid nodules that cause neither pain nor restricted mobility do not need to be treated. However, if they occur on the hands, they can become a cosmetic problem. Treatment is by oral medication containing cortisone that slows down or completely stops the inflammatory process.

Changing your diet can help with this. Cortisone injections injected directly into the lump can help relieve the pain. Another treatment option is surgical removal of the rheumatic nodules.


Preventive measures can include plenty of exercise and an appropriate diet. When exercising, make sure that the joints are protected. Swimming and cycling are recommended. Food rich in vitamins and as few animal products as possible on the menu are also considered prophylactic measures.

Food high in sugar and fat can promote the formation of rheumatic nodules. Victims need to take care of their bodies. This means that they should react to the smallest changes. If they register that they feel pain in their joints after eating a piece of cake, they will avoid sugary delicacies in the future.


If there is a rheumatic nodule in the hand, this may require surgical intervention, which in turn requires follow-up treatment. The surgeon surgically removes the knots. In most cases, the affected hand does not need to be immobilized after the rheumatic nodules have been removed. In some patients, however, it is necessary to apply restraining bandages.

This procedure protects the wounds from infection or damage on the one hand and keeps the fingers in the desired position on the other. The patient can bend and stretch his fingers.

If the wound is healing according to plan, the doctor will change the bandage two or three times in the first week. Finally, after about 14 days, the stitches are removed. There is hardly any painful discomfort for the patient. Only the tightening of the thread with tweezers can be felt.

If the patient suffers from pain or swelling after the operation, the hand is usually immobilized. The doctor will also administer an anti-rheumatic drug to relieve the pain and reduce the swelling.

After the operation, the treated hand is gradually reintroduced to everyday stress. However, this can take a few weeks or even months. Regular hand baths in lukewarm water are recommended to help.

You can do that yourself

Rheumatoid nodules are a painful symptom of the joints, such as the finger joints. They are also accessible to self-help in everyday life after the disease has been properly diagnosed by the general practitioner or orthopedist treating you. Rheumatoid nodules are treated by patients with heat or cold. In this context, it cannot be generally predicted what is good for the patient. Individual testing by those affected is important here.

Exercise is important with rheumatoid nodules, even though patients prefer to avoid it because of the pain. But a protective posture leads to stiffening of the joints, which are already affected by the rheumatic disease, and a negative circulation can develop. Exercise in warm water can also be particularly helpful. Warm baths can also be effective if they are tolerated by the patient. This must also be tested.

Diet is also an important factor in rheumatic diseases and thus also with regard to the development of rheumatic nodules. Studies have already proven many times that meat and sausages are rather unfavorable in connection with rheumatism and the associated arthritis processes. Therefore, Mediterranean tasting with fruit and vegetables is helpful in preventing the formation of new knots. Drinking a sufficient amount also makes sense in order to eliminate inflammatory processes in the body more quickly.

Rheumatic Nodules