Rheumatoid nodule

Case contributed by Abdallah El-Sayed Allam
Diagnosis probable

Presentation

Rheumatoid arthritis patient, positive rheumatoid factor (RF) treated by subcutaneous methotrexate 12.5mg/week, oral low dose corticosteroids, presented with a subcutaneous nodule over the extensor surface of the elbow.

Patient Data

Age: 38 years
Gender: Male
ultrasound
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Info

Ultrasound revealed ill defined hetero-echoic, non erosive compressible nodule with no posterior shadowing and no Doppler signal.

A and B : Nodule over the extensor surface of the elbow

C: Longitudinal scan of the nodule.

D: Compressiblity.

E. Doppler.

Case Discussion

Differential diagnosis:

  1. Olecranon bursitis
  2. Rheumatic nodule
  3. Gouty tophi

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