This picture depicts severe mutilating rheumatoid arthritis of the hands with the presence of hard rheumatoid nodules over some of the joints. Evidence of tenosynovitis over the dorsums of the wrists and ulnar deformity from the destructive arthritic process is also apparent. As you would expect by the name, these lesions normally occur in patients with rheumatoid arthritis. The lesions are usually asymptomatic, and are most often located over the extensor surfaces of joints on the hands, wrists, elbows, knees, ankles, and toes. For more information about Rheumatoid Nodules, click here.