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Osteonecrosis and monoarticular rheumatoid arthritis treated with intra-articular adalimumab

We report a 54-year-old patient with RA presented with osteonecrosis (ON) and monoarthritis of left knee remitting in the last 2 years. Monoarthritis was resistant to disease-modifying antirheumatic drugs (DMARDs) and intra-articular corticosteroids. Intra-articular administration of adalimumab provided a good clinical and radiographic response. Synovitis resolved and osteonecrosis disappeared almost totally.