Deep or subcutaneous nodules with a "rheumatoid" histologic picture may occur in rheumatoid arthritis, rheumatic fever, or granuloma annulare. Occasionally such nodules appear alone, in patients with no other manifestation of any of these diseases.
Isolated deep "rheumatoid" nodules in children almost always follow a benign course similar to that of granuloma annulare. Children with such nodules rarely develop rheumatic fever and have never been reported to develop rheumatoid arthritis.
In adults, on the other hand, such isolated "rheumatoid" nodules may be the first sign of rheumatoid arthritis. Two patients with such a history are presented.