Whilst such deformations in large articular bones, such as hips and knees can be rectified via arthroscopic surgery, smaller joints such as those in the fingers cannot be rectified using these approaches resulting is severe disability in many patients with RA.1, 2, 3, 4, 5,48,67 To date, the only therapeutics that impinge on this process of joint destruction are anti-TNF therapies which have been found to limit the activation of synovial cells and the progression of tissue destruction.3 The gene discussed is TNF; the disease is rheumatoid arthritis.