A recent "Pathological Case of the Month" by Yavuz et al1 considered a child with a history of polyarthritis, morning stiffness, normal results of a laboratory evaluation, and pathologically diagnosed rheumatoid nodules of the forearms, knee, thigh, and ankle. The authors described a child with a history that is most consistent with an inflammatory arthritis, and then they discussed benign rheumatoid nodules. Yavuz et al agree that the diagnosis is uncertain in this child. However, the title of the "Diagnosis and Discussion" section is "Benign Rheumatoid Nodules." Benign rheumatoid nodules (also called pseudorheumatoid nodules) are common2 and are not associated with illness. I am concerned that the child described has systemic rheumatic disease or that systemic rheumatic disease will develop. This child was not a well child according to the history, and benign rheumatoid nodules are found in well children. It is true that the patient had normal
Cawkwell GD. Benign Rheumatoid Nodules. Arch Pediatr Adolesc Med. 1994;148(11):1219. doi:10.1001/archpedi.1994.02170110105023
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