Would you escalate therapy in a patient with rheumatoid arthritis without synovitis, but a new rheumatoid nodule?

The appearance of a new nodule in someone without synovitis is puzzling. If it is truly a rheumatoid nodule, their RF should be positive. These patients have a heightened risk for the development of full blown RA in the future. However, the appearance of a nodule without synovitis being present does...