Quick Summary
- Rheumatoid nodules are firm lumps that occur in some people with rheumatoid arthritis (RA).
- They are usually benign and often painless.
- Nodules most commonly form near joints or pressure points.
- Many do not require treatment.
- Medical evaluation is appropriate if nodules become painful, infected, or interfere with function.
Overview
Rheumatoid nodules are firm lumps that develop most often under the skin in people with rheumatoid arthritis (RA). They are a recognized manifestation of RA and are usually noncancerous. Many nodules cause little to no discomfort and don’t require treatment, but some can become painful, infected, or interfere with function, which may prompt medical evaluation.
What Are Rheumatoid Nodules?
Rheumatoid nodules are localized lumps associated with RA. They typically form beneath the skin and are most often found near joints or areas exposed to repeated pressure or trauma. Not everyone with RA develops nodules.
- They occur in association with RA.
- They are usually benign (noncancerous).
- They vary in size.
- They are commonly firm to the touch.
Where Do Rheumatoid Nodules Commonly Appear?
Nodules most often develop at pressure points or sites of repeated use.
Common locations
- Fingers and knuckles
- Elbows (especially the tip of the elbow)
- Forearms
- Heels, including the back of the heel and Achilles area
Less common locations
- Scalp (particularly in people who are immobile or spend long periods in bed)
Can Rheumatoid Nodules Occur Inside the Body?
Yes. In some cases, rheumatoid nodules develop in internal (systemic) locations rather than under the skin.
internal sites
- Lungs
- Eyes
- Vocal cords
- Heart (cardiac structures)
Internal nodules are uncommon and are often found incidentally during imaging or specialist examinations. Many do not cause symptoms.
What Do Rheumatoid Nodules Feel Like?
Most rheumatoid nodules are painless.
- They are often firm.
- They usually do not hurt.
- Tenderness or pain can occur, particularly if the nodule is irritated or under repeated pressure.
Are Rheumatoid Nodules Dangerous?
Most nodules are not dangerous and do not require treatment.
Possible complications
- Skin breakdown or ulceration over the nodule
- Infection
- Compression of nearby structures, including nerves
- Interference with movement or mechanical function
What Causes Rheumatoid Nodules?
The exact cause is not fully understood.
- Rheumatoid nodules are linked to the same immune and inflammatory processes that drive RA.
- They are associated with heightened immune system activity.
- Not everyone with RA develops nodules, and it is not possible to predict who will.
Who Is More Likely to Develop Rheumatoid Nodules?
Certain factors are associated with a higher likelihood of developing nodules:
- More severe rheumatoid arthritis
- Positive rheumatoid factor (RF)
- Presence of anti–cyclic citrullinated peptide (anti-CCP) antibodies
- Smoking
- Repeated pressure or physical trauma to specific areas
Methotrexate and Accelerated Nodulosis
Some people with RA develop multiple small nodules over a short period, a phenomenon known as accelerated nodulosis.
- Accelerated nodulosis has been reported in association with methotrexate use.
- These nodules often appear on the hands or fingers.
- Nodules may develop even when joint symptoms are otherwise well controlled.
How Are Rheumatoid Nodules Diagnosed?
Diagnosis is often clinical.
- Medical history and physical examination
- Imaging studies such as X-ray or CT scan in selected cases
- Biopsy when the diagnosis is uncertain or features are unusual
Accurate diagnosis helps distinguish rheumatoid nodules from other lumps, infections, or soft tissue masses.
Treatment Options
Many rheumatoid nodules do not need treatment.
Treatment may be considered when nodules
- Cause pain
- Become infected or ulcerated
- Interfere with movement or daily activities
- Cause significant cosmetic or quality-of-life concerns
Management options
- Observation for stable, painless nodules
- Corticosteroid injections into or near the nodule in selected cases
- Surgical removal when nodules cause significant problems
Nodules can recur after treatment.
Can Rheumatoid Nodules Go Away?
Some rheumatoid nodules shrink or disappear over time, while others persist or increase in size. The course varies from person to person.
When to See a Doctor
Medical evaluation is recommended if:
- You notice a new lump or changes in an existing nodule
- A nodule becomes painful, ulcerated, or shows signs of infection
- A nodule interferes with movement or daily function
Frequently Asked Questions
What does a rheumatoid nodule look like?
A rheumatoid nodule is typically a firm lump under the skin, most often near joints or pressure points.
Are rheumatoid nodules painful?
Most are painless, but pain or tenderness can occur if the nodule is irritated, infected, or under repeated pressure.
What are rheumatoid nodules made of?
They are composed of characteristic tissue changes associated with inflammation in rheumatoid arthritis.
Do rheumatoid nodules come and go?
Some may resolve on their own, while others remain or grow. The pattern varies between individuals.
Can rheumatoid nodules go away on their own?
Yes. Some nodules resolve without treatment, while others persist.
How do you get rid of rheumatoid nodules?
Many do not require treatment. When necessary, options include corticosteroid injections or surgical removal.
Are rheumatoid nodules cancerous?
No. They are usually benign and not a sign of cancer.
Can lifestyle changes prevent rheumatoid nodules?
There is no guaranteed way to prevent them. Managing RA and avoiding smoking may reduce risk.
APA Reference List
Cleveland Clinic. (n.d.). Rheumatoid nodules: What they are, causes & treatment. Retrieved December 30, 2025, from https://my.clevelandclinic.org/health/symptoms/rheumatoid-nodules
DermNet New Zealand. (n.d.). Rheumatoid arthritis and the skin. Retrieved December 30, 2025, from https://dermnetnz.org/topics/rheumatoid-arthritis-and-the-skin
Hasham, S., & Burke, F. D. (2007). Diagnosis and treatment of swellings in the hand. Postgraduate Medical Journal, 83(978), 296–300. https://pmc.ncbi.nlm.nih.gov/articles/PMC2600075/
Ikeda, K., et al. (2025). Recurrently infected rheumatoid nodule causing posterior interosseous nerve palsy: A report of a rare case. Cureus. https://pmc.ncbi.nlm.nih.gov/articles/PMC12327935/
Johns Hopkins Arthritis Center. (n.d.). Rheumatoid arthritis symptoms. Retrieved December 30, 2025, from https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-symptoms/
Mayo Clinic Staff. (2025). Cellulitis: Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cellulitis/symptoms-causes/syc-20370762
National Rheumatoid Arthritis Society (NRAS). (n.d.). Rheumatoid nodules in rheumatoid arthritis (RA). Retrieved December 30, 2025, from https://nras.org.uk/resource/rheumatoid-nodules/
National Rheumatoid Arthritis Society (NRAS). (n.d.). Rheumatoid nodules (PDF). Retrieved December 30, 2025, from https://nras.org.uk/resource/rheumatoid-nodules/?print-pdf=3796
Primary Care Dermatology Society. (2021, July 30). Rheumatoid nodules. https://www.pcds.org.uk/clinical-guidance/rheumatoid-nodules
Tilstra, J. S., & Lienesch, D. W. (2015). Rheumatoid nodules. Dermatologic Clinics, 33(3), 361–371. https://doi.org/10.1016/j.det.2015.03.004