TNF and rheumatoid arthritis: Suppression of joint inflammation is essential in modern management of rheumatoid arthritis (RA) and is a key element in clinical trials (1, 2) and is traditionally assessed by clinical joint examination, but magnetic resonance imaging (MRI) and ultrasound have been demonstrated to be more sensitive than clinical assessment for detecting joint involvement (3–6) and have been shown to be sensitive to change during treatment with TNF inhibitors (7–10).