Radiologic observation: repair of focal bone erosions after humanized antitumor necrosis factor antibody adalimumab therapy in a patient with rheumatoid arthritis

Erosions of the bone and cartilage are considered as a cardinal feature of rheumatoid arthritis (RA) leading to joint destruction and functional limitations. This report is a radiologic observation of distinguishable bone erosion repair with concomitant increase of radio-opacity of trabecular bones after 15 months of antitumor necrosis factor (TNF) antibody adalimumab therapy in a 26-year-old woman with RA resistant to conventional therapy. Although the introduction of anti-TNF antibodies has contributed to the slowing and arrest of RA progression, destruction itself has been generally acknowledged as an irreversible process with little hope (only 1.8% of erosions) in resolution. Our patient's dramatic structural retrieval is a discrepant, yet notable case pivoting the previous belief on the skeletal restoration capacity of anti-TNF antibody into a circulating cytokine-dependent manner.