What is your approach to differentiating and managing DMARD-induced nodulosis (induced by methotrexate or leflunomide for example) from "de novo" RA nodules in seropositive RA patients?

Though there are some clinical distinctions that may help to differentiate RA-related nodules from those associated with either methotrexate (MTX) or leflunomide (LEF), one may never be fully certain. RA-related nodules tend to be bigger and fleshy to palpate whereas drug-related nodule formation is...