Anti-type II collagen (anti-CII) antibodies have been reported in between 3% and 27% of patients with rheumatoid arthritis (RA).1 3 In contrast with anti-cyclic citrullinated peptide (anti-CCP) antibodies,4 5 anti-CII antibodies are absent before the onset of synovitis6 and decrease over the first few years of disease.2 3 Anti-CII antibody levels thus appear to peak around the time of diagnosis of RA when they are associated with active inflammation.3 The pathological processes operating in the joints of patients with very early synovitis who develop RA are distinct from those in other patients with early synovitis and are characterised by a cytokine profile …