DIAGNOSTIC CHALLENGES IN DORSAL HAND MASSES: RHEUMATOID NODULES WITH CONCOMITANT RADIAL NERVE NEUROMA

REXHEPI, Maligona and ATANASOVA, Ana and MIRCEVSKA ZHOGOVSKA, Elizabeta and GEORGIEVA, Gordana (2026) DIAGNOSTIC CHALLENGES IN DORSAL HAND MASSES: RHEUMATOID NODULES WITH CONCOMITANT RADIAL NERVE NEUROMA. In: INTERNATIONAL CONFERENCE “FROM RESEARCH TO APPLICATION”, 20 May, 2026.

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Abstract

Soft-tissue masses of the dorsal hand present a diagnostic challenge because they may originate from inflammatory, vascular, tenosynovial, or neoplastic conditions with similar clinical manifestations. Rheumatoid nodules are the most common extra-articular manifestation of rheumatoid arthritis; however, involvement of the dorsum of the hand associated with extensor tendon structures is uncommon and may mimic benign or malignant soft-tissue tumors. We present a rare case of concomitant rheumatoid nodule and radial nerve neuroma in a 62- year-old patient with two slowly enlarging masses on the dorsum of the left hand and lateral forearm. The patient experienced progressive difficulty with hand movement due to the size of the dorsal lesion and pain on percussion over the forearm mass. Clinical examination revealed a firm, immobile dorsal hand lesion and a painful forearm tumor-like formation, creating a preoperative diagnostic dilemma regarding surgical management. Both lesions were surgically excised and evaluated histopathologically. The dorsal hand mass was identified as a rheumatoid nodule characterized by inflammatory infiltrates, fibrinoid deposits, and synovial hyperplasia, while the forearm lesion was confirmed as a radial nerve neuroma. At one-year follow-up, no recurrence was observed, and the patient maintained full, painless hand function. This case emphasizes the importance of considering rheumatoid nodules in the differential diagnosis of dorsal hand masses and highlights the essential role of histopathological evaluation in establishing accurate diagnosis and guiding treatment.

Item Type: Conference or Workshop Item (Paper)
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine, Health and Life Sciences > School of Medicine
Depositing User: Unnamed user with email zshi@unite.edu.mk
Date Deposited: 22 Sep 2026 09:21
Last Modified: 22 Sep 2026 09:21
URI: http://eprints.unite.edu.mk/id/eprint/2434

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