The History of the American College of Rheumatology Image Library

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Late-night gatherings; long hours of avid discussion weighing the merits of resolution quality, light, hues and tones; and camaraderie among members forged through a shared interest in maintaining the highest fidelity to their craft and profession—these are among the vivid memories of those who participated in the early years of building what is today known as the ACR Image Library.

Currently housing more than 2,000 images, the ACR Image Library has served for years as a major repository of high-quality images of rheumatic diseases used by rheumatologists and others around the world. Every year new images are added to the online collection, making this an up-to-date dynamic resource for teaching and education.

As with all successful endeavors, laying the foundation for the Image Library and its sustaining service to the field of rheumatology and other clinical areas took years of hard work, adherence to rigorous standards and a strong vision of the educational excellence offered by teaching through seeing.

The figure on the June 2020 Arthritis & Rheumatology cover, from the ACR Image Library, is a photomicrograph showing birefringent, needle-shaped monosodium urate crystals from the joint fluid of a patient with gout, as demonstrated with compensated polarized light microscopy. This image illustrates the enduring educational value of the Image Library, first conceived in 1956, nearly 65 years ago.

The Image Library evolved alongside evolutions in the organization of rheuma­tology itself. Several name changes occurred over the past near century. In 1927, the American Committee to Control Rheumatism was formed, and in 1937 it was renamed the American Rheumatism Association (ARA). It was under the ARA in 1956 that the first iteration of the Image Library emerged as a modest collection of pathology slides.

The Arthritis and Rheumatism Foundation incorporated in 1948 and, in 1965, changed its name to the Arthritis Foundation, at which time the ARA became the professional section of the Arthritis Foundation. In 1985, the ARA separated from the Arthritis Foundation, and in 1988 the ARA changed its name to the American College of Rheumatology (ACR). The Image Library was continued under the auspices of the ACR.

In 1958, the library was expanded to include clinical images of rheumatic diseases and became known as the Clinical Slide Collection on the Rheumatic Diseases. In 1972, the first collection of clinical images was published. The committee then overseeing the collection was the Audiovisual Aids Subcommittee. Today, the Image Library Subcommittee, under the ACR’s Committee on Education, continues the Image Library work.