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Table 2: Stages of infiltration damage by modeling substances. |
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|
Stage |
Forecast |
Features |
|
1 |
Good |
Excellent response to rheumatological-pharmacological treatment (combining different substances such as methotrexate, prednisone, colchicine, and folic acid). They respond in less than four months. Most of them do not require surgical treatment. Recurrences can be treated in the same way. An excellent long-term response is expected |
|
2 |
Reserved |
They usually have an excellent response to pharmacological treatment after about six months. After that time, the infiltrated tissues will show favorable changes, making them candidates for scheduled surgical treatment to remove most affected tissues. Reconstructive options for these patients are usually successful |
|
3 |
Limited |
Their response to treatment is limited; they temporarily improve their conditions but have increasingly frequent symptomatic periods, which limits the possibility of receiving repeated pharmacological treatment. As soon as their general conditions improve, they should undergo surgical treatments to remove most of the infiltrated tissues in one or several surgeries and try to improve their quality of life by eliminating most of the infiltrated substances from their body. Reconstructive options in these patients are more limited because they present a higher degree of involvement and have a high incidence of complications related to poor healing and increased tissue friability |
|
4 |
Poor |
Poor short-term prognosis, very severe, and may die of multiple organ failure. In these patients, there is no good response to the usual pharmacological treatment, as it can be aggressive and aggravate the patient’s conditions, so they are not candidates for surgical treatment; emergency hospitalization is recommended |