Synovial Biopsy, Synovium, Synovial Fluid & Arthrocentesis

History of Penn Rheumatology Photo/Slide Viewer


A History of Penn Rheumatology

Rheumatology at Penn has a long history of contributions and innovations that goes back as far as 1882 when Morris Longstreth at Pennsylvania Hospital published a monograph, “Rheumatism, Gout and Some Allied Disorders.” Ralph Pemberton, now honored yearly at an Annual Lectureship at the Philadelphia Rheumatism Society who was on the Penn faculty and a professor of medicine, started the first arthritis clinic at Presbyterian Hospital in 1926. He was an organizer of the American Committee for Control of Rheumatism which evolved into the American Rheumatism Association (ARA). He served as President of the ARA in 1938-9. In 1929 Pemberton authored his first edition of a text called “Arthritis and Rheumatoid Conditions” that was to evolve over the years at Penn into a major text.


Bernard Conroe opened the first arthritis clinic at the Hospital of the University of Pennsylvania (HUP) in 1937, taught medical students here, was credited with coining the term “rheumatologist,” and in 1940 authored “Arthritis and Allied Conditions” through three editions, until his early death in 1945. At that time Joseph Hollander moved from Pennsylvania Hospital, took over the arthritis clinic at HUP and started the first fellowship program in 1949-50. Hollander edited a 4 th edition of Arthritis and Allied Conditions in 1949, added authors from all over the world, first included the collagen vascular diseases and established this as “the text” for rheumatology for many years. Hollander also led important initiatives for the ARA in guiding development of the journal Arthritis and Rheumatism in 1958 and board certification for Rheumatology by the American Board of Internal Medicine so that he had quite a major impact on development of our specialty. He served as ARA president in 1961-2 and led in attracting fellows from other countries who were to become international leaders in rheumatology.


Hollander’s many contributions over his years at Penn included the development and evaluation of depot corticosteroids for intra-articular injection, a systematic approach to analysis of synovial fluid that led to identification of urate crystals in the fluid with his fellow Dan McCarty, and characterization of immune complexes in rheumatoid synovial effusion cells (RA cells) that remains an under appreciated component of the disease process in RA. Hollander developed a rheumatology program at Children’s Hospital, and performed fascinating experiments on the effect of climate changes on joint symptoms with his climate chamber. He practiced and taught at Penn until in his 80’s.

In 1967 Ralph Schumacher finished a fellowship at Robert Brigham in Boston and joined Hollander as a second full time Rheumatologist. With the help of donations from Hollander’s patients he set up what proved to be a productive pathology, electron microscopy, and small animal research laboratory. Investigating synovium and synovial fluid in a variety of types of arthritis, he continued the tradition of developing educational material by editing 3 editions of The Primer on the Rheumatic Diseases and initiating the Journal of Clinical Rheumatology which he continues to edit. Contributions among his more than 500 papers included identification of apatite crystals in synovial fluids raising the still to be explored role of the virtually ubiquitous calcium crystals in osteoarthritis. He identified bacterial DNA and RNA in joints not only in reactive arthritis but also in some clinically normal joints. The downscaling of his lab left implications of this still to be explored.

In 1969 with the arrival of Arnold Relman as chief of Medicine, Allen Myers was recruited from MGH. He dramatically expanded the Division role in treatment of systemic lupus and other collagen-vascular diseases and focused the growing program on a series of clinical research projects with more than 30 papers including studies on esophageal and duodenal function in scleroderma, phagocyte function of neutrophils, neurologic features of lupus, and mechanisms of gonococcal arthritis .

Robert Zurier came to Penn to lead the Rheumatology program in 1980 with his expertise in laboratory studies of fatty acids, prostaglandins, and cytokines. This led to productive collaborations and reports on prostaglandin metabolism and new insights including that gammalinolenic acid could have comparable anti-inflammatory effects to NSAIDs. Zurier obtained the first NIH rheumatology research training grant at Penn. He received a Guggenheim fellowship to the Imperial Cancer Research Lab in London.

Robert Eisenberg in 1995 moved from the University of North Carolina bringing his established research work in murine autoimmunity. Innovative work here included focus on the roles of B lymphocytes in RA. Eisenberg led a team studying aspects of murine lupus and mechanisms involved in pathogenesis of lupus. He won the Lady Barbara Colyton prize in autoimmunity. Philip Cohen, also from North Carolina, joined Eisenberg in 1999 and continued his bench research on apoptosis, lupus, and did important studies on B cell depletion for Sjögren syndrome. He took over the VA rheumatology program and served on important NIH, ACR and AF grant review committees.He also served as an associate editor for Arthritis and Rheumatism.

Gary Koretzky, a graduate of Penn’s MD and PhD programs, came from Iowa in 1999 to the Dept. of Pathology to direct an immunology research program. In 2005 he became chief of Rheumatology. He was elected to the AAAS and Institute of Medicine, mentored basic scientist post doctoral fellows and PhD students and is editor of Immunologic Reviews. He did funded research on lymphocyte immunology and supervised a NIH training grant.

Sharon Kolasinski, a former fellow at Penn came from Indiana University in 1996 and in 2008 assumed the position of interim chief of Rheumatology here. She initiated and then greatly expanded the mpact of a national course at Penn for first year Rheumatology fellows, grew our clinical faculty, and took an active role in ACR program directors activities. She won an ACR Clinical Scholar award. Kolasinski authored papers on alternative medicine, “Why did you become a rheumatologist,” and clinical studies.

Other important contributions came from former fellows who remained for a time on our faculty. Sergio Jimenoz developed a scleroderma clinical and laboratory research program and evaluated penicillanine for therapy. He studied the roles of cytokines in collagen synthesis.

Antonio Reginato expanded on his observations from Chile on calcium pyrophosphate deposition disease (CPPD disease) and became the world expert on this, determined genetic factors in some cases and worked on other previously unrecognized crystal diseases publishing on oxalate crystals and liquid lipid crystals. He co-edited an atlas of synovial fluid with Schumacher.

Daniel Baker did extensive studies on models of crystal and particle induced inflammation and wrote a review on monoarthritis for the New England of Medicine. Lawrence Levinthal provided a resource for our patients with fibromyalgia and published a series of clinical studies.

Theodore Pincus performed basis studies on the possible role of viruses in initiation of autoimmune diseases and published on herpes virus monoarthritis.

Stuart Silverman established a focus on osteoporosis and published a study evaluating the possible role of EB viral antigens in early RA.

Lan Chen initiated a series of studies on acupuncture, sleep and fibromyalgia and coordinated gout and synovial fluid investigations. Brian Mandel studied pathogenesis of gout and treatment of crystal induced inflammation with diets enriched in fatty acids.

Other former faculty members not previously mentioned have had various important impacts.

Peter Callegari

Balu Athreya

William Williams

Daniel Albert

Terri Finkel

Rheumatology Leadership at Penn

1945-1972 Joseph Hollander

1972-1978 Allen Myers (later acting chairman of Medicine and Dean at Temple)

1978-1980 Ralph Schumacher

1980-1991 Robert Zurier (later Chief of Rheumatology, University of Massachusetts)

1991-1995 Ralph Schumacher

1995-2004 Robert Eisenberg

2005-2006 Gary Koretzky (later the chair for Research and chief scientific office in the Penn Dept. of Medicine and Interim Director, Penn Institute of Immunology)

2008-2011 Sharon Kolasinski (later Head, Division of Rheumatology, Cooper University)

2011- Peter Merkel

Veterans Administration Hospital

1967-2007 Ralph Schumacher

2007-2008 Phillip Cohen (later Chief of Rheumatology at Temple)

2008- Sally Pullman-Mooar



2003- Fred Vivino


ARA (ACR) Presidents with Penn Connections

Ralph Pemberton 1938-1939

Joseph Hollander 1961-1962

Daniel McCarty

William Kelley

University of Pennsylvania Rheumatology Fellows (date of fellowship completion)

1950 Ernest M. Brown, Jr. MD

1951 Ralph A. Jessar, MD

1951 Charles Y. Brown, MD

1952 Bruce J. Frain, MD

1953 Michael Zacco, MD

1954 Nathan M. Smukler, MD

1955 Robert Moore, MD

1956 Rush J. Shanahan, MD

1957 Douglas F. Raymond, MD

1958 Carlos M. Lackington, MD

1958 Klaus Miehlke, MD

1959 Sidney Cooperband, MD

1960 Daniel J. McCarty, Jr, MD

1960 Oskar Plevko, MD

1961 Ronald A. Restifo, MD

1961 Hugo Fort, MD

1962 Sarantos J. Yeostros

1963 Eduardo Castro-Murillo, MD

1963 Gonzalo Astorga, MD

1964 Ross Jeremy, MD

1964 Andre Lussier, MD

1965 Richard Drewyer, MD

1966 Antonio J. Reginato, MD

1966 Tito P. Torralba, MD

1967 Evan T. Owen, MD

1969 Rodanthi Kitridou, MD

1970 Ramon Navarro, MD

1970 Helmut Sorenson, MD

1971 Robert Turner, MD

1971 Carlos A. Agudelo, MD

1972 Michael D. Reynolds, MD

1973 Antonio Reginato, MD

1974 Sergio A. Jimenez, MD

1974 Bonnie B. Dorwart, MD

1974 Ronald Krauser, MD

1974 Eric Gall, MD

1975 Eliseo Pascual, MD

1975 Jerome Weisberg, MD

1975 Roger Traycoff, MD

1976 Kenneth Maurer, MD

1976 Jeffrey Miller, MD

1976 Peter Hasselbacher, MD

1977 Charles Ludivico, MD

1978 Mark Bookspan, MD

1978 Frank Passero, MD

1978 Wolfe J. Blotzer, MD

1979 Gary Gordon, MD

1979 Abraham Weinberger, MD

1980 Daniel G. Baker, MD

1980 Edward V. Lally, MD

1980 Ira Pardo, MD

1981 David A. Allan, MD

1981 Ella S. Feldman, MD

1982 Ciro J. Carafa, MD

1982 James P. Dwyer, MD

1982 Bruce Freundlich, MD

1982 Barbara Ziehmer, MD

1983 Myron Kleiner, MD

1983 Arthur Huppert, MD

1984 Barbara Shoback, MD

1984 Paul Williamson, MD

1984 John S. Bomalaski, MD

1985 Brian F. Mandell, MD

1985 Sally Pullman-Mooar, MD

1986 Michael Rosen, MD

1986 Catherine Ryan, MD

1987 James Freeman, MD

1987 Ginger D. Constantine, MD

1987 Suzanne Algeo, MD

1988 Worawit Louthrenoo, MD

1989 David Makover, MD

1989 Frederick B. Vivino, MD

1989 Lawrence Leventhal, MD

1989 Michael Borofsky, MD

1989 Deborah DeMarco, MD

1990 Barbara Ostrov, MD

1991 Joan Von Feldt, MD

1991 Nancy Murphy, MD

1991 Edna Schwab, MD

1991 Michael Lewko, MD

1992 Thaila Ramanujam, MD

1992 Albert Lee, MD

1992 Greg Keenan, MD

1993 Suzanne Zorn, MD

1994 Daniel Norden, MD

1994 Monica Luchi, MD

1995 Atul Singhal, MD

1995 Rula Bulbul, MD

1995 Stephen Goodman, MD

1996 Kristin Gowin, MD

1997 Richard Siegel, MD

1997 Jay Getsy, MD

2000 Elana Eisner, MD

2000 Andrew Mermelstein, MD

2000 Areena Swarup, MD

2000 Elizabeth Hsia, MD

2000 Lan Chen, MD, PhD

2000 Robert Meador, MD

2000 Tassamne Kitumnuaypong, MD

2001 Amy Evangelisto, MD

2001 Marianthi Kiriakidou, MD

2001 Stephanie Flagg, MD

2001 James Chung, MD

2002 Vidya Parameswaran, MD

2002 Sadia Khan, MD

2002 Birgit Kovacs, MD

2002 Benjamin Hsu, MD

2002 Lisabeth Scalzi

2002 Ying Du, MD

2003 Jonathan Dunham, MD

2003 Kathy Dennis, MD

2003 Smeetha Morthala, MD

2003 Dai Li, MD

2004 Amir Moldovan, MD

2004 Michael Schuster, MD

2004 Chacko Alapatt, MD

2005 Jenifer Kwan Morley, MD

2005 Aarti Malik, MD

2005 Kevin Khaw, MD

2006 Saurin Mehta, MD

2006 Smita Gupta, MD

2006 Seo Young Kim, MD

2007 Jane Kang, MD

2007 Marissa Blum, MD

2007 Naoto Yokogawa, MD

2008 Joshua Baker, MD

2008 Soumya Rao, MD

2008 Supriya Sehgal, MD

2009 Alexis Ogdie, MD

2009 Anon Abuel-Hajia, MD

2009 Richa Mishra, MD

2010 Ghaith Noaiseh, MD

2010 Samir Bhangle, MD

2010 Sophia Li, MD

2011 Rennie Rhee, MD

2011 Roodabeh Koolaee, MD

2011 Yiu Tak Leung, MD


Former Fellows have become leaders in Academic medicine and industry

Rheumatology Division Chiefs

Nathan Smukler, Jefferson

Daniel McCarty, Hahneman Medical College, Wisconsin

Andre Lussier, Sherbrook, Canada

Antonio Reginato, Cooper

Robert Turner, Emory

Sergio Jimenez, Jefferson

Eric Gall, Arizona

Roger Traycoff, S. Illinois

Edward Lally, Brown

Barbara Ostrov, Hershey


Department of Medicine Chairs

Daniel McCarty, Chicago

Eric Gall, Med College Chicago

Peter Hasselbacher, Kentucky

Brian Mandel, Cleveland Clinic


Other Academic Rheumatologists

Rodanthi Kitridou, USC

Carlos Agudelo, Bowman Gray

Sally Pullman-Mooar, Jefferson, Penn

Frederick Vivino, Jefferson, Penn

Deborah DeMarco, U Mass

Joan Von Feldt, Penn

Edna Schwab, Penn

Lisabeth Scalzi, Hershey

Seo Young Kim, BU

Lan Chen, Penn

Amy Evangelisto, Penn

Mananthi Kiriakidov, Cooper

Jonathon Dunham, Penn

Robert Meador, Baylor

Jane Kang, Columbia

Marissa Blum, Temple

Joshua Baker, Penn

Alexis Ogdie, Penn

Gaith Noaiseh, Pitt

Other International Academic Leaders

Gonzala Astorga, Chile

Tito Torralba, Philippines

Evan Owen, Australia

Eliseo Pascual, Spain

Abraham Weinberger, Israel

Worawit Louthreneo, Thailand

Tassanee Kitumauaypong, Thailand

Naoto Yokogawa, Japan

Industry Leaders

Daniel Baker

Bruce Freundlich

Barbara Ziehmer

Ginger Constantine

Greg Keenan

Elizabeth Hsia

Benjamin Hsu


Barbara Shoback, FDA

Richard Siegel, NIH


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