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Spondyloarthritis Program

Spondyloarthritis is a group of inflammatory diseases affecting the spine and joints. It is estimated that about 2.7 million Americans, or nearly one in every 100 individuals, have spondyloarthritis. Disorders in this group include ankylosing spondylitis (a.k.a. axial spondyloarthritis, or axSpA), psoriatic arthritis, arthritis related to Crohn's disease and ulcerative colitis, and reactive arthritis. Chronic back pain is the most common symptom of spondyloarthritis, but it can also cause inflammation of tendons and joints. Some patients develop inflammation of eyes (Uveitis), skin (psoriasis), and intestines (inflammatory bowel disease). These patients are at increased risk of osteoporosis and cardiovascular disease.

Abhijeet Danve, MD, leads the Yale Spondyloarthritis Program, which was established in February 2019 to provide comprehensive care to patients with spondyloarthritis and conduct research aimed at finding cost-effective strategies and discovering biomarkers for early and accurate diagnosis and management.

Our talented team is committed to:

Improving Early Diagnosis
The average delay in diagnosis of axSpA is 8-11 years. Despite the availability of effective medications, patients experience back pain, disability, and poor quality of life due to delayed diagnosis and lack of timely referrals. We seek to improve awareness and early diagnosis through education campaigns encompassing lectures, group discussions, and social media directed at non-rheumatology physicians.

Providing Outstanding Specialty Care
Our team includes a rheumatologist, physical therapist, rehab medicine specialist, spine surgeon, pain specialist (for musculoskeletal disease), as well as dermatologists, a gastroenterologist, ophthalmologist, psychologist, nutritionist, and cardiologist.

Groundbreaking Research
We strive to fill knowledge gaps and develop novel diagnostic markers and personalized treatments to improve symptoms and quality of life. We firmly believe in patient-centered and patient oriented research.

Patient education and Involvement
We will provide beginner level and advanced patient education and offer a patient support group.
  • Patients will soon be able to communicate patient -reported outcomes using iPads, and automated scores will be generated in the electronic health record to enhance medical decision making.
Working with You
  • We can co-manage the disease along with you or we can assume the care for your patients.
  • Your patients will be able to participate in clinical trials to test novel therapies as well as clinical research studies.

    Goals and Impact

    Goals
    • Deliver patient-centered care for spondyloarthritis by a team of experts.
    • Build a spondyloarthritis registry of patient in New England for prospective studies.
    • Conduct translational research to discover biomarkers for accurate diagnosis and management of spondyloarthritis.
    • Partner with regional, national, and international scientific communities for collaborative projects.
    • Conduct pilot studies aimed at leveraging federal and foundation support for larger studies

    Impact
    • Rapidly growing referrals from physicians across Connecticut
    • Selected as the site for a prospective multinational multi-center CLASSIC study for modification of classification criteria for axSpA.
    • Secured a $200K research grant from Novartis for an investigator-initiated study to develop a tool for the early identification of axSpA.

    For Referring Physicians

    New patients are seen on a referral basis only using the new patient referral form which should be faxed to 203-785-7053 or for patients who are currently seen within the Yale New Haven Health and its partner organizations, a referral must be entered into EPIC by choosing the YNH Arthritis & Rheumatology option.

    Program Leadership

    Our Team

    • Badr Al Bawardy, MD

      Assistant Professor of Medicine (Digestive Diseases); Program Director, Inflammatory Bowel Disease Fellowship, Digestive Diseases

      Badr Al Bawardy, MD, is a gastroenterologist at Yale Medicine specializing in inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis. He performs the following procedures: esophagogastroduodenoscopy (a diagnostic endoscopic procedure for the upper digestive tract, also known as EGD), colonoscopy, chromoendoscopy, and video capsule endoscopy.   Dr. Al Bawardy earned his M.D. with distinction from the George Washington University. After medical school, he completed an internal medicine residency, gastroenterology fellowship and a specialized inflammatory bowel disease fellowship at the Mayo Clinic in Rochester, MN, which gave him valuable experience treating the disease alongside leaders in the field.   IBD is a chronic medical condition affecting the gut, and often requires doctors to build long-term relationships with patients to manage their care. This type of medical care was appealing to Dr. Al Bawardy. He is a proponent of shared decision making in management of IBD. When meeting patients, Dr. Al Bawardy discusses risks, benefits, and goals of treatment with his patients so they can make an informed decision about their care. He also asks them about their preferences related to lifestyle and career, for example. He takes all this information into account when developing a treatment plan.   “My patient-care philosophy is that the patient always comes first,” he says.   In addition to caring for IBD patients, Dr. Al Bawardy’s clinical interests include evaluating and treating patients with celiac disease, microscopic colitis and  general gastroenterology. Dr. Al Bawardy also conducts research and is an assistant professor of medicine (digestive diseases) at Yale School of Medicine.
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    • Jeffrey Cohen, MD

      Assistant Professor of Dermatology; Director, Psoriasis Treatment Program

      Jeffrey M. Cohen, MD is a board-certified medical dermatologist and the Director of the Psoriasis Treatment Program at the Yale School of Medicine.  He treats the full spectrum of skin conditions and has a special interest in disorders that involve the immune system, especially psoriasis and eczema.  “It is an exciting time to be a dermatologist,” he says “because there are so many innovative treatments that can be used to improve the quality of patients’ lives and their overall health.” Dr. Cohen graduated from Harvard Medical School and completed his dermatology residency at the New York University School of Medicine where he received training in the most advanced diagnostic and therapeutic techniques in dermatology.  He is “dedicated to treating each patient like a member of my own family and tailoring treatments to each individual.” Dr. Cohen has been active in dermatology research since he was a medical student, during which time he dedicated a year to research in the Department of Dermatology at the Brigham and Women’s Hospital in Boston.  His current research focuses on the epidemiology of skin conditions, relationships between skin disorders and other medical problems, and the way that dermatologic care is delivered.  Dr. Cohen has been an author of over eighty peer-reviewed articles on psoriasis and other topics in dermatology.  Dr. Cohen says that “through my research, I am able to improve our current knowledge and contribute to future advances in dermatology.” Dr. Cohen sees patients at the Yale Medicine Dermatology offices in New Haven and Branford.
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    • Abhijeet Danve, MBBS, MD, FACP, MHS

      Associate Professor of Medicine (Rheumatology); Director of Yale Spondyloarthritis Program, Rheumatology; Co-chair, Safety and Quality Council, Rheumatology

      Dr Abhijeet Danve is a rheumatologist who enjoys serving adult patients with inflammatory rheumatic diseases. He has particular interest in psoriatic arthritis, ankylosing spondylitis and gout. Dr Danve is certified in internal medicine (2012) and rheumatology (2014) by American Board of Internal Medicine. He is certified by American College of Rheumatology in musculoskeletal ultrasound (RhMSUS) and uses musculoskeletal ultrasound routinely in his practice. He is recipient of the Marshall J Schiff Fellowship Award by American College of Rheumatology (2013), Distinguished fellow award by American College of Rheumatology (2015) and Jane Bruckel Early Career Investigator award by Spondylitis Association of America (2019). Dr. Danve is an active member of SPARTAN (Spondyloarthritis Research and Treatment Network), GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis), American College of Physicians and American College of Rheumatology. He enjoys teaching medical students, residents and fellows.
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    • Mark Dundas, MD

      Assistant Professor Of Clinical Orthopaedics; Team Physician for CT Sun (WNBA) and New England Black Wolves (NLL), Orthopaedics & Rehabilitation

      Mark Dundas, MD, is a physiatrist (a doctor who specializes in physical medicine and rehabilitation) who focuses on nonsurgical sports medicine and orthopedic care. Dr. Dundas developed a special interest in sports medicine after having his own share of injuries. “I’ve known what it’s like to have an injury and go through the rehabilitation process—there is a struggle coping with the loss of your function, managing pain as you reactivate your muscles, and working through the fear of moving again,” he says.As a physiatrist, Dr. Dundas focuses on the whole person as opposed to one specific body part. “Our joints are wonderfully and frustratingly connected. So, I need to examine the surrounding body regions to design the best rehabilitation plan. We are learning more and more how pain changes more than just the injured anatomic structure. I often talk to my patients about how they're sleeping, their mood, their diet, and how their life has changed because of the problem they've come to talk to me about. I look at a picture that is often more than just what the MRI or X-ray shows,” he says. Dr. Dundas uses a variety of approaches that includes exercise and may include medications, injections, and physical therapy to help patients reach their goals and return to their activities. He also helps patients prepare for surgery. “The better you are moving before going into surgery, the better you will do after surgery,” he says. “Regenerative medicine is a growing and exciting field of orthopedics that has the potential to improve function and potentially avoid surgery in conditions like arthritis and tendinopathy. I am excited to be a member of the team here at Yale and engage in clinical trials with these new treatment options.” As assistant professor of clinical orthopedics at Yale School of Medicine, Dr. Dundas often draws upon his early work in a biomechanics laboratory, where he studied how people move. “I've been able to build on that knowledge and use it when I'm assessing patients,” he says. “I tell patients there's no bad exercise or activity, but you can do anything improperly and increase your risk for pain and injury. That’s where things like form and mechanics come into play. Running is an example of a sport where form is important,” he says. “When I'm assessing a runner, I look at everything: the whole kinetic chain, or how the whole body moves. If there's a weakness or restriction around your ankle, it can change stresses at your hip and vice versa. Everything's connected and it is my job to help keep you moving.”
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    • Ninani Kombo, MD

      Assistant Professor of Ophthalmology and Visual Science; Affiliated Faculty, Yale Institute for Global Health; Affiliated Faculty, Yale Institute for Global Health

      Dr. Kombo received her B.A. from Mount Holyoke College and her M.D. from Yale University School of Medicine, where she also completed her ophthalmology residency. She completed fellowship training in Uveitis and Ocular Immunology at The Massachusetts Eye Research and Surgery Institution (MERSI) under the mentorship of Dr. C. Stephen Foster where she was the Chief Clinical Fellow. Dr. Kombo has served on the faculty at the Yale School of Medicine in the Department of Ophthalmology and Visual Sciences since 2014. She is Director of the Uveitis Service and is a comprehensive ophthalmologist. Dr. Kombo is the Director of Medical Student Education in Ophthalmology. She volunteered in Nassau, Bahamas, at Princess Margaret Hospital for 6 years, providing resident teaching and helping in the care of the underinsured and underserved Bahamian population. She hopes to continue working in other international settings and is currently working with Drs. Martone and Alden Mead to secure a partnership with LV Prasad Institute in Hyderabad, India.
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    • Charles Odonkor, MD, MA

      Assistant Professor; Assistant Professor, Orthopedics and Rehabilitation

      As a physiatrist (a doctor who practices physical medicine and rehabilitation), Charles Odonkor, MD, is used to explaining his medical specialty.“As humans, we evolved to be creatures of movement—you stop moving, you get sick. And sometimes chronic illness or pain will stop you in your tracks. That’s where a physiatrist steps in,” Dr. Odonkor says. “I use my toolbox, which includes medications, exercises, physical modalities, or interventions to help you get back to moving again and doing what you enjoy.”Physiatry, he explains, goes beyond thinking about the body as just parts to looking at how the nerves, bones, muscles, and tendons are connected, with each one impacting function and movement. Dr. Odonkor completed a fellowship in pain medicine at Harvard Medical School and a physiatry residency and patient safety and health systems design fellowship at Johns Hopkins School of Medicine. As an alumnus of Yale School of Medicine, he is excited to return to Yale to bring his expertise in advanced pain intervention techniques, regenerative medicine and neuromodulation to alleviate chronic pain.Dr. Odonkor is passionate about providing exceptional patient care experience and designing value care processes that promote comprehensive functional restoration. He says that in tackling challenging conditions like complex regional pain syndrome, lumbar stenosis, and hip, spine, and joint pain, “one of the things I enjoy most is forming a therapeutic relationship with patients. That’s where the healing starts.”“To me, pain is like a big black box. We are in the 21st century and there still is so much we don’t know about it,” he adds.His research interests include wearable devices that involve biosensors that, for a patient with a chronic back pain, for example, track changes in range of motion, gait speed, physical activity, and other measures of function.Dr. Odonkor is an assistant professor of orthopedics and rehabilitation at Yale School of Medicine.
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    • Kanishka Rajput, MD, FASA

      Assistant Professor of Anesthesiology

      Dr. Rajput is an Assistant Professor of Anesthesiology in the Division of Pain Medicine at Yale University. Dr. Rajput graduated from the esteemed All India Institute of Medical Sciences in India.  After finishing her internship at Yale University School of Medicine, she completed Anesthesiology residency and fellowship in Interventional Pain at the Medical College of Wisconsin. Dr. Rajput specializes in Interventional Pain procedures for a wide variety of chronic non malignant and malignant pain syndromes. She treats all patients using a multidisciplinary approach with various modalities encompassing interventions, non opioid analgesics, physical therapy and pain psychology. She offers a variety of interventional techniques that complement her comprehensive treatment approach for each patient. Actively involved in clinical research, her focus is on studying trajectories of chronic post surgical pain, devise strategies aimed at reducing perioperative opioid consumption with use of multi modal analgesics and outcomes of various interventional pain procedures.
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    • Robin Raju, DO

      Assistant Professor Of Clinical Orthopaedics; Medical Director, Yale New Haven Health Rehabilitation Committee, Physical Medicine & Rehabilitation

      Physiatrist (Physical Medicine and Rehabilitation Specialist) focused on comprehensive treatment of musculoskeletal pain, chronic pain, overuse injuries, and sports and trauma-related problems.Utilizes specialized physical therapy programs, minimally invasive procedures - such as ultrasound or fluoroscopy-guided injections, and alternate modalities.Research interest in regenerative medicine and the effectiveness of spine and joint injections.
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    • Arya Varthi, MD

      Assistant Professor of Orthopaedics and Rehabilitation; Assistant Professor of Orthopaedic Surgery, Orthopaedic Surgery; Spine Surgery Fellowship Director, Orthopedic Surgery

      Dr. Varthi is an Assistant Professor of Orthopaedic Surgery who specializes in spine surgery. He serves as the spine surgery fellowship director and has expertise in minimally invasive and open surgeries of the cervical, thoracic and lumbar spine and treats problems related to trauma, deformity, tumor and degenerative disorders. He believes in a patient-centered approach to medical care and exhausts non-operative treatments prior to considering surgery. Dr. Varthi has published research on a wide variety of orthopaedic and spinal disorders and contributed to leading spine surgery textbooks. His research and that of collaborators has been presented at regional and national spine meetings.Born and raised in Connecticut, Dr. Varthi graduated Phi Beta Kappa from the University of Chicago with a degree in Economics. He was a member of the varsity tennis team from 2003-2004. He earned a medical degree at the University of Connecticut and completed an orthopaedic surgery residency at Yale University School of Medicine. He then obtained a fellowship in spine surgery at Rush University Medical Center in Chicago.
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