Imaging Findings

1. From the X-ray plain films of both wrists: the distal radial physis (growth plate) appears mildly rough, widened, and irregular.
2. Especially in the left wrist, more pronounced changes are observed in the distal radial physis region, including abnormal signals at the physis and slight alterations in its marginal contour.
3. On MRI T2-weighted images, the distal radial physis shows high signal intensity, suggesting edema or inflammatory changes.
4. No obvious acute tear is noted in the surrounding soft tissues (e.g., ligaments, articular cartilage), but potential chronic overuse should be considered.

Potential Diagnoses

1. Gymnast Wrist (Chronic Distal Radial Physis Injury)
   Due to prolonged, high-intensity load-bearing activities in gymnastics, the distal radial physis undergoes repeated compressive stress, leading to potential damage or growth abnormalities. Radiographic features such as fuzziness, widening, irregularity of the physis, and T2 hyperintensity on MRI support this diagnosis.
2. Stress Fracture or Salter-Harris Injury
   Wrist pain can also occur in adolescents during growth spurts due to these injuries. Although similar in presentation to Gymnast Wrist, acute Salter-Harris fractures are typically linked to distinct high-impact trauma, whereas stress fractures must be differentiated from chronic physeal injuries.

Final Diagnosis

Considering the competitive gymnast background, repetitive wrist stress, and imaging findings of distal radial physeal abnormalities, the most likely diagnosis is: “Gymnast Wrist” (Chronic Distal Radial Physis Injury). Further clinical assessment, pain evaluation, and additional ultrasound/follow-up MRI can help determine any associated ligament damage or instability.

Treatment Plan and Rehabilitation

1. Conservative Treatment and Rest:
• Temporarily discontinue or reduce weight-bearing gymnastic maneuvers that provoke pain, giving the physis adequate rest. Gradually resume once pain subsides.
• Use of wrist braces or supports can help reduce local stress.
• Anti-inflammatory and analgesic medications (e.g., NSAIDs) may be used to relieve pain and inflammation.

2. Rehabilitation Training and Exercise Prescription:
• Once pain considerably subsides, begin a staged wrist rehabilitation program.
• Initial Phase (Weeks 1-2): Focus on gentle wrist mobility, including stretching exercises and passive joint movements within a pain-free range. Frequency: 1-2 times per day, 5-10 minutes each session.
• Intermediate Phase (Weeks 3-4): Gradually introduce resistance exercises (e.g., light resistance bands or small dumbbells), emphasizing stability of the wrist and forearm muscles. Frequency: 3-4 times per week, 15-20 minutes per session.
• Advanced Phase (Weeks 5-8): Integrate core and upper-limb strength exercises relevant to gymnastics (e.g., push-ups, core stabilization), while avoiding prolonged high-intensity weight-bearing on the wrists. Frequency: 3-5 times per week, progressively increasing complexity.
• Following the recovery phase, adhere to the FITT-VP principles (Frequency, Intensity, Time, Type, Volume, Progression), making individualized adjustments based on pain and functional capacity.

3. Surgical Treatment:
• If there is a significant cessation of radial growth or marked discrepancy between the radius and ulna (e.g., notable positive ulnar variance), surgical intervention (such as distal ulnar epiphyseodesis or ulnar shortening osteotomy) may be considered.
• Surgical indications should be evaluated based on bone age and overall growth potential.

Disclaimer:
This report solely serves as a referential analysis based on the provided imaging and clinical information; it does not replace in-person consultation or professional medical advice. Specific treatment decisions should be made by a professional medical team after comprehensive evaluation of the patient's individual condition.