Fistulization of rheumatoid joints. Spectrum of identifiable syndromes.

Eight patients with rheumatoid arthritis developed cutaneous fistulae adjacent to affected joints. Rheumatoid factor was positive in eight patients; subcutaneous nodules were noted in seven. Two patients had features of rheumatoid vasculitis. A spectrum of syndrome characterized by cutaneous fistulae was observed. Three patients showed classical fistulous rheumatism. Four patients developed septic arthritis which subsequently fistulized; in two, infection was associated with total joint replacement. One patient showed a cutaneous sinus accompanying a large calf cyst. A variety of diagnoses must be considered when cutaneous fistulae appear near joints in patients with rheumatoid arthritis.