Rheumatoid vasculitis bilateral calf pain

Updated July 19, 2017

Leg pain, especially pain in the calf, can be caused by a number of problems. Patients are often initially treated for their symptoms of muscle pain with non-steroidal anti-inflammatory drugs and muscle relaxants. Only when they do not respond to these drugs do their doctors look further to find a cause for their continuing pain. Whether or not you have rheumatoid arthritis, your doctor may want to rule out other causes of your pain before determining that it is vasculitis.

Rheumatoid Arthritis

Although you may feel very alone in your symptoms and pain, rheumatoid arthritis is the most commonly found connective tissue disease. The National Institutes of Health says it occurs in over 1.3 million people in the U.S. adult population. It is classified as an autoimmune disease, which means your immune system is attacking you, mistaking your own self for an enemy invader. Anyone can develop the disease. According to the National Institutes of Health, it is found 2 to 3 times more frequently in women than men and more often in older adults. No ethnic group or race is immune from its challenges. When you have rheumatoid arthritis, you are risk for developing vasculitis. It can occur any place you have blood vessels.


Vasculitis is an inflammation of your small or medium-sized arteries. When it occurs in both legs, it is called bilateral. When your calf is involved, the vasculitis can be mistaken for muscle strain, a bruising injury, infection, a drug reaction, clogged arteries, diabetes, a blood clot or some cancers. It is important to have any painful or persistent leg pain evaluated.

Vasculitis occurs in about 20 per cent of people with rheumatoid arthritis, according to My RA Central, and can be mild and limited or wide spread and life-threatening. It is important to treat any vasculitis. Untreated, the inflammation may cause obstruction of the arteries, which decreases blood flow to the tissue. If the blood flow becomes obstructed enough, tissue death can follow.


Symptoms of vasculitis may include tenderness, pain, swelling or a hard lump under the skin of your calf. These lumps are usually about the size of a pea. Sometimes the pain is excruciating, making it difficult to walk or even to have clothing touch the site of the pain.


Your doctor may diagnose you quickly and with great certainty, or he may take longer, need more tests and still leave you with questions. He may order a MRI, muscle biopsy or ultrasound, as well as lab work, to determine the source of your leg pain.


Corticosteroids are used to treat vasculitis. Once they are started, you should feel relief fairly quickly. These steroids can be given along with some of the other drugs you may already be taking for rheumatoid arthritis. The Annals of Rheumatic Disease reports that although almost all cases of vasculitis respond to steroids, up to 54 per cent of cases will relapse and eventually need immunosuppressive drugs for further control. These are also called cytotoxic drugs, meaning they kill certain types of cells. Almost all of the medications used to treat arthritis and vasculitis have some side effects and risk factors. Your doctor will want to check your bloodwork regularly to catch any problems early.

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About the Author

Kathy Boll Hughes began writing pamphlets for Newborn ICU parents in 1971 and continues to write educational medical articles. Her published work is currently found on and She is also a ghost writer for a just-released medical text. Hughes holds a Bachelor of Science in Nursing from San Diego State.