Abstract
A 45-year-old man with moderately severe erosive rheumatoid arthritis presented with a several-month history of a painful left calf. He had a 1.5-year history of rheumatoid arthritis affecting both elbows, wrists, metacarpophalangeal joints, proximal interphalangeal joints, knees, ankles and metatarsophalangeal joints. Examination of the joints revealed diffuse synovitis with bilateral knee effusions and a visibly enlarged left calf with a palpable mass extending inferiorly from the popliteal fossa (Panels A and B). The erythrocyte sedimentation rate was 58 mm per hour, and the C-reactive protein level was 37.6 mg per liter. Tests were positive for rheumatoid factor and antibodies against . . .
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