Frayha R, Ayyash R, Gehshan A, Gemayel N
Johns Hopkins Med J. 1976 Dec;139 SUPPL:69-72.
A middle-aged man developed multiple subcutaneous rheumatoid granulomata, high titer of rheumatoid factor, diffuse interstitial pulmonary fibrosis and digital clubbing in the absence of clinicoradiological evidence of synovial disease. This patient supports the concept of rheumatoid disease without arthritis.