A 53-year-old man presented with firm, non-tender subcutaneous nodules overlying his hands and elbows. These had been progressive in number and size over 7 years. Rheumatoid factor was negative but a biopsy was consistent with rheumatoid nodules. He has never had any joint symptoms and remains otherwise asymptomatic. Examination is unremarkable except for the nodules described. We believe this man has rheumatoid nodules with no evidence of arthritis.