Medical Analysis Report

I. Radiological Findings

Based on the provided X-ray imaging data, multiple irregularly low-density regions can be observed in the patient’s forearm, both hands, and left chest wall, mainly involving tubular bones (such as phalanges, metacarpals, forearm bones, etc.) and some soft tissues:

• Lesions in bone: Predominantly eccentric or near-central, relatively round or irregular radiolucent lesions in the bone, with a few lesions showing small, punctate calcifications inside.
• Lesions in soft tissue: Possible soft tissue masses in the forearm and hand; in some areas, small high-density calcifications can be seen, which may represent phleboliths formed within hemangiomas.
• Chest X-ray: Localized thickening of the left chest wall soft tissue, displaying similar findings in that area.

Overall, the findings suggest multiple benign tumor-like lesions simultaneously present in bone and soft tissue, with features of both chondroma and hemangioma. The disease appears to have a chronic, progressive course.

II. Potential Diagnoses

Considering the patient’s age, clinical presentation, and imaging characteristics, the following are the diagnostic considerations:

1. Maffucci Syndrome: A non-hereditary congenital mesodermal dysplasia that can present with multiple enchondromas and cavernous or other types of hemangiomas. Classic symptoms include limb deformities and subcutaneous hemangiomas, sometimes with punctate calcifications (phleboliths). The findings in this case strongly match such a presentation.
2. Ollier Disease: Also known as multiple enchondromatosis, usually lacking the distinct soft tissue hemangioma manifestations and without significant presence of phleboliths. If there were no soft tissue lesions or prominent hemangiomas in this case, Ollier disease should be considered. However, given the extensive hemangioma findings, Ollier disease is less likely.
3. Other Rare Syndromes Involving Osteochondromas and Hemangiomas: These should be differentiated clinically; however, typical clinical and imaging features often do not present as clearly as Maffucci Syndrome.

III. Final Diagnosis

Taking into account the 30-year-old male patient with multiple cartilaginous bone lesions in the forearm and both hands, concurrent soft tissue cavernous hemangiomas, the presence of punctate calcifications (potential phleboliths), and the chronic progressive nature of the disease, the most likely diagnosis is Maffucci Syndrome.

There is a need to closely monitor the risk of malignant transformation of these lesions and to conduct regular follow-up imaging checks (X-ray, MRI, etc.). If necessary, perform a biopsy or other auxiliary examinations to rule out possible malignancies such as sarcoma.

IV. Treatment Plan and Rehabilitation

In managing Maffucci Syndrome, the general therapeutic strategies include:

• Conservative Follow-up: If lesions do not cause significant compression or functional impairment, clinical and imaging follow-up can be conducted regularly to monitor for enlargement or potential malignant changes.
• Surgical Intervention: In cases of marked bone deformities, functional impairment, or suspicious malignant changes, surgical resection, bone reconstruction, or corrective surgery may be considered.
• Biopsy if Needed: If hints of malignant transformation arise (e.g., increased bone pain or evident progressive bone destruction on X-ray), a biopsy is required to confirm histopathology.

Rehabilitation and Exercise Prescription Suggestions:
Because the patient’s bones may remain relatively fragile and there are soft tissue hemangiomas, it is important to avoid trauma and excessive loading during exercise. A gradual progression of low-impact exercises is recommended, following the FITT-VP principles (Frequency, Intensity, Time, Type, Progression, and Personalization):

1. Frequency: Engage in low-intensity physical activities 3–4 times per week, avoiding excessive fatigue.
2. Intensity: Keep the intensity at a level where the patient feels relaxed or only slightly tired, avoiding high-impact exercises (e.g., running, jumping, or heavy squats). Possible options include swimming, low-intensity aerobics, or light resistance band exercises for the upper limbs.
3. Time: Each session can last 15–30 minutes, gradually extending the duration based on tolerance.
4. Type: Focus on flexibility and stability training, with the addition of light resistance exercises. Emphasis should be placed on maintaining joint range of motion and protecting muscle strength.
5. Progression: Once comfortable with the initial exercise volume, gradually increase the duration or intensity. If there is a significant improvement in muscle strength and joint function, moderate weight-bearing exercises can be introduced under professional supervision.
6. Personalization: Adjust the specific movements and loading according to the patient’s lesion location, scope, and soft tissue condition.

During rehabilitation, closely monitor any pain or discomfort. Any significant discomfort, joint swelling, or changes in local masses should prompt immediate imaging reevaluation and notification to the attending physician.

Disclaimer: This report is provided for informational purposes only and is not a substitute for an in-person consultation or a professional physician’s diagnosis and treatment. If the patient experiences any special circumstances or changes in symptoms, please seek immediate medical attention and further evaluation.