In a case of rheumatoid arthritis, granulomatous nodules were observed clinically in the subcutaneous tissue and at necropsy in the synovial membranes, pericardium, myocardium, subchrondral bone, and vertebrae. The granulomatous process in the vertebrae in this case caused compression fracture of the twelfth thoracic vertebra and appeared similar roentgenographically to such other destructive lesions as multiple myeloma, metastatic carcinoma, and tuberculosis. This case, together with three others reported briefly, emphasizes the fact that the granulomatous inflammation which is so commonly observed in the subcutaneous tissues and occasionally in the viscera of patients with rheumatoid arthritis may also involve the vertebrae. This fact is important in the consideration of the differential diagnosis of destructive lesions of vertebrae in patients with rheumatoid arthritis.