<prompt> Extra articular manifestation of rheumatoid arthritis is:Av fistulaCutaneous hypomelanosisSplenic atrophySubcutaneous nodules  <response>: Ans: d Subcutaneous nodulesRef: Harrison, 18 ed. pg. 2087 As many as 40 of people may show extra articular manifestations Usually occur in individuals with high R F positivity of high ACCP. Rheumatoid nodules seen in upto 20-30 individuals with RA. Usually periarticular or extensor aspect but can be seen anywhere.Extra articular manifestations in RARespiratoryGastrointestinalPleral effusion with low sugarXerostomiaPneumothoraxParotid enlargementRheumatoid noduleKaplan syndromeDysphagiaInterstitial fibrosisMesentric artery occlusionPneumoniaRenalPulmonary hypertensionPyelonephritisAnalgesic nephropathyCardiacPericarditisendocarditisCard iomyopathyMyoca rd ial infarctionAmyloidosisOcularEpisc leritisscleri tisKerato conjunctivitis siccaConduction defectscardiac arrhythmiasMitrsl aortic incompetenceScleromalacia perforans EarDefective hearing-Ossicular chain involvementNervous systemAtlantoaxial subluxationQuad ri paresis Peripheral neuropathyAutonoimic neuropathyMononeuritis multiplexEntrapment neuropathyPyoderma gangrenosumSkinDermal atrophyLeg ulcersnodules BonesPeriarticular osteoporosis 