Language
Country/Area
No result found
Amazing rheumatoid nodules: Why do they pop up around elbows and knuckles?
Rheumatoid nodules are lumps or swollen areas that appear on the surface of the skin, usually near the olecranon of the elbow or the interphalangeal joints of the knuckles, but they can appear elsewhere in the body. . These nodules are almost exclusive to patients with rheumatoid arthritis, although multiple nodules may rarely be present in the absence of rheumatoid arthritis (i.e., rheumatoid sarcoidosis). To understand the characteristics of these nodules and their causes, one first needs to understand the basics of rheumatoid arthritis and its pathology.
Currently, the exact formation process of rheumatoid nodules is unknown, but several hypotheses have been proposed to explain their formation.
In the context of rheumatoid arthritis, the growth and development of patients' rheumatoid nodules are mainly affected by inflammatory factors. Studies have pointed out that rheumatoid nodules often appear in trauma-prone areas. Trauma in these places can lead to the accumulation of inflammatory granules, which in turn triggers a secondary inflammatory response, ultimately leading to fibrin release and necrosis. Inflammation of specific blood vessels also activates complement components, leading to the deposition of rheumatoid factor and fibrin, which further form the elusive rheumatoid nodules.
Pathology of rheumatoid nodules
When these nodules are examined histologically, they are found to consist of fibrous tissue surrounding a center of fibrous necrosis. Some small nodules have only a single necrotic center, whereas large nodules are often multiluminal and may have multiple septations or be connected to a large bursa.
The histological feature is a layer of closely packed macrophage and fibroblast cell stalks arranged in a radial pattern.
Clinically, rheumatoid nodules in patients with rheumatoid arthritis often develop in extension areas, and common sites for these nodules include the hands and elbows. Although the nodules themselves usually do not cause pain and dysfunction, their presence is often distressing to patients.
Risk factors
Statistics show that about 5% of patients with rheumatoid arthritis have nodules two years before the onset of the disease, and over time, about 20-30% of patients will develop nodules. Risk factors for developing rheumatoid nodules include smoking and trauma to small blood vessels.
In addition, the presence of the HLA-DRB1 gene is also associated with the risk of rheumatoid nodules. Certain risk factors such as high levels of serum rheumatoid factor and long-term use of methotrexate may be associated with nodules. related to the development.
Related diagnosis and treatment methods
The diagnosis of rheumatoid nodules is usually made by a rheumatologist based on clinical symptoms, with the location and development of the nodules being the main reference. Regarding treatment methods, some samples have shown that local steroid injections have achieved good results in reducing nodule size, while surgery is usually performed when the nodules are inflamed or necrotic.
It is worth noting that conventional rheumatoid arthritis drugs such as anti-TNF therapy have little effect on nodules, and some patients may experience nodule growth while taking methotrexate.
Conclusion
Although rheumatoid nodules are common, their occurrence is caused by many factors, including genes, environment and physiological conditions. Although there are no effective complete preventive measures to date, active disease management and lifestyle modifications remain important measures for patients with rheumatoid arthritis to reduce risk and maintain quality of life.
Are you confused about the origin and management of rheumatoid nodules, or do you have other special opinions?
