43 patients with erosive hand osteoarthritis were included in a crossover, randomized design to evaluate the efficacy of adalimumab as a treatment option. Patients were randomized to the order in which they received intervention with either adalimumab or placebo for 12 weeks. There was an 8-week washout period between treatment phases. Improvement in patient-reported pain, stiffness, and function scores, and MRI-assessed synovitis and bone marrow lesion scoring systems during 12 weeks of subcutaneous adalimumab 40mg every two weeks did not significantly differ than those observed during 12 weeks of subcutaneous placebo.