Medical Imaging Analysis Report

I. Imaging Findings

1. Based on the provided bilateral wrist X-ray images (frontal and lateral views), no obvious new fracture line is observed. The distal radius appears generally normal, and the radial articular surface is basically flat.
2. The patient’s report of "tenderness on light touch in the anatomical snuffbox region" often suggests a possible scaphoid fracture, but the imaging does not clearly demonstrate any fracture signs. If necessary, follow-up imaging or MRI may be considered to rule out an occult fracture.
3. Local bony fusion can be seen in the proximal and distal carpal bones, suggesting congenital carpal coalition. Common fusion patterns include lunate-triquetrum or capitate-hamate fusion; the images also indicate a similar pattern of fusion.
4. The soft tissue structures do not show significant swelling or effusion on these images, and there is no obvious narrowing or disruption in the joint space.

II. Potential Diagnoses

1. Scaphoid Fracture: The patient fell on an outstretched hand and complains of pain in the anatomical snuffbox region, making a scaphoid fracture a common concern. However, no clear fracture signs are visible on this X-ray. Vigilance is still needed.
2. Congenital Carpal Coalition: Imaging shows the fusion of local carpal bones (e.g., lunate with triquetrum, or capitate with hamate), consistent with congenital carpal coalition. This is often an incidental finding and usually does not require special intervention if asymptomatic.
3. Other Wrist Soft Tissue Injuries: If imaging rules out fractures, attention should be given to potential soft tissue injuries (ligaments, joint capsule, etc.) such as sprains or strains.

III. Final Diagnosis

Considering the patient’s history of falling on an outstretched hand, imaging results, and clinical symptoms, the most likely diagnosis is:
Congenital Carpal Coalition, with no apparent acute fracture signs.
If pain persists or worsens, it is recommended to undergo MRI or other advanced imaging to rule out an occult scaphoid fracture or ligamentous injury.

IV. Treatment Plan and Rehabilitation Program

1. Conservative Treatment:

• If no definitive fracture is found, temporary wrist immobilization (e.g., light cast or wrist brace) can help alleviate pain and promote tissue healing.
• Monitor pain changes, and follow up with regular X-ray exams or MRI as needed to rule out fractures or ligament injuries.

2. Surgical Treatment:

• If an occult scaphoid fracture is confirmed and there is displacement or compromised blood supply, surgical intervention may be required.
• For congenital carpal coalition without functional impairment or pain, surgical treatment is generally not necessary.

3. Rehabilitation/Exercise Prescription Recommendations (FITT-VP Principle):

• Early Stage (when pain is significant):
  • Frequency: 1-2 times per day; avoid high-load wrist activities.
  • Intensity: Proceed without causing significant pain; mainly gentle fist clenching and slight flexion/extension exercises.
  • Time: About 5-10 minutes per session.
  • Type: Gentle wrist joint exercises such as wrist flexion/extension, forearm pronation/supination.
  • Progression: Gradually increase the range and frequency of movement as pain subsides.
• Middle to Late Stage (after pain subsides):
  • Frequency: 3-4 times per week.
  • Intensity: Gradually increase with the use of resistance bands or small weights.
  • Time: 15-20 minutes per session.
  • Type: Functional training for the wrist and forearm, such as light grip exercises, resisted wrist flexion/extension, and finger dexterity training.
  • Progression: Increase difficulty and duration based on recovery, incorporating full-body coordination exercises.

Throughout this process, pain and swelling should be closely monitored. If significant discomfort arises, seek medical advice promptly and adjust the training plan accordingly.

V. Disclaimer

This report is based solely on the provided imaging data and limited clinical information for reference purposes. It cannot replace an in-person consultation or professional medical opinion. If you have any concerns or if symptoms worsen, please seek medical attention or consult a specialist for more accurate and individualized diagnostic and treatment options.