Medical Imaging Analysis Report

Patient Information: Male, 39 years old, computer worker, bilateral wrist pain for over 3 months, with no history of trauma.

I. Imaging Findings

• MR images show multiple cystic lesions near the wrist joint, round or oval in shape, with well-demarcated borders.
• The lesions are hyperintense on T2-weighted images and relatively hypointense on T1-weighted images, consistent with cystic changes containing mucoid or fluid components.
• Some lesions connect to or closely adhere to the joint space or tendon sheath region.
• No obvious abnormalities, destruction, or signs of inflammation are observed in the surrounding soft tissues or bones.

II. Potential Diagnoses

1. Wrist Ganglion (Joint or Tendon Sheath Cyst)
   Cause: Mucinous substance within the joint cavity or tendon sheath protrudes through points of increased local pressure or weak structural areas.
   Imaging Features: High signal on T2-weighted images, low signal on T1-weighted images, well-defined borders, connected with the joint cavity or tendon sheath.
2. Tenosynovial Giant Cell Tumor
   Cause: A proliferative lesion of local tissues in the tendon sheath.
   Imaging Features: Can manifest as a soft tissue mass; some cases may show heterogeneous or low signal on MRI. Unlike common cystic lesions, most are solid lesions.
3. Synovitis or Tenosynovitis
   Cause: Overuse, chronic injury, or autoimmune processes leading to inflammation of the synovium or tendon sheath.
   Imaging Features: Presents with soft tissue swelling or synovial thickening; contrast-enhanced scans (when performed) may exhibit enhancement. Its cystic appearance is generally less typical than that of ganglia.

III. Final Diagnosis

Based on the patient’s prolonged bilateral wrist discomfort, absence of significant trauma history, and imaging findings of multiple cystic lesions with high T2 and low T1 signal intensities that connect to the joint or tendon sheath, the most likely diagnosis is a wrist ganglion (tendon sheath cyst). If there are any remaining doubts, ultrasound-guided aspiration or pathological examination can be pursued to definitively exclude other possibilities.

IV. Treatment Plan and Rehabilitation Program

1. Conservative Treatment

• Rest and Immobilization: During severe symptoms, use a wrist brace or splint for a short period and avoid prolonged keyboard or mouse use.
• Anti-inflammatory and Analgesic Therapy: Nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve pain and inflammation.
• Observation and Follow-up: For small cysts with mild symptoms, regular follow-up is recommended. Some may spontaneously regress.

2. Interventional or Surgical Treatment

• Aspiration and Sclerotherapy: For recurrent or large cysts, ultrasound-guided aspiration followed by injection of a sclerosing agent can reduce recurrence.
• Surgical Excision: If the cyst significantly impairs function or frequently recurs, surgical excision (open or arthroscopic) is an option. Efforts should be made to remove the cyst wall and any connecting tract.

3. Rehabilitation and Exercise Prescription

Rehabilitation should be customized to the individual, following the FITT-VP principle:

• Frequency (F): 3–5 times per week, adjusted based on pain levels.
• Intensity (I): Start with light to moderate intensity wrist exercises, avoiding excessive load or extreme flexion/extension.
• Time (T): Approximately 20–30 minutes per session, divided into sets with adequate rest.
• Type (T): Focus on range-of-motion exercises (gentle stretching, wrist flexion/extension), gradually introducing isometric and isotonic exercises for the forearm muscles.
• Progression (P): After symptom relief, gradually incorporate light resistance exercises (e.g., using light dumbbells for wrist extensors/flexors) and extend workout duration according to recovery status.

Note: If there is any concern about bone or joint risks, exercises should be carried out under the supervision of a qualified rehabilitation therapist or physician. Pain and range of motion should be monitored continually to ensure safety.

V. Disclaimer

This report is based on the current history and imaging data provided, serving as a reference analysis. It is not a substitute for in-person consultation or professional medical advice. If you have any questions or if symptoms worsen, please seek medical attention or further relevant examinations promptly for a definitive diagnosis.