Medical Imaging Analysis Report

I. Radiological Findings

Based on the provided X-ray, CT, and MRI images, the following main features are observed:

• In the right upper limb (including the forearm and hand bones), unilateral, segmental, irregular cortical thickening is noted, displaying a “dripping wax” appearance (similar to candle wax dripping).
• CT plain scans show highly dense bone overgrowth with marked cortical thickening; the boundary appears wavy or lobulated.
• On MRI, the corresponding region shows decreased signal intensity, suggesting inward (into the medullary cavity) cortical involvement.
• The lesion is predominantly distributed along the long axis of the bone, without noticeable crossing of joint spaces.
• No obvious swelling or significant abnormal enhancement of the surrounding soft tissues is observed, and there is no evident sign of fracture.

II. Potential Diagnoses

Considering the patient’s age (30 years old, male), gradual onset of right upper limb pain, and the aforementioned imaging findings, the following differential diagnoses are proposed:

1. Melorheostosis (Leri’s disease):
   • Characterized by “dripping wax” cortical thickening, often segmental and unilateral.
   • Typically occurs in young to middle-aged adults and can be associated with localized pain and limited joint mobility.
   • Imaging often reveals irregular cortical thickening in long bones or the phalanges.
2. Bone Island(s) (Enostosis):
   • Usually presents as localized sclerotic foci, often smaller in extent; does not typically exhibit the pronounced “wax-dripping” cortical changes.
3. Hypertrophic Osteoperiostitis:
   • Can involve cortical thickening of bone but is often noted in infection or chronic inflammatory conditions; clinical presentation may demonstrate clear signs of inflammation or infection.
4. Other Rare Sclerotic Bone Diseases (e.g., Osteosclerosis):
   • May show increased bone density but usually lack the characteristic “dripping wax” cortical thickening.

III. Final Diagnosis

After a comprehensive analysis of the patient’s age, symptoms, and the classic “wax-dripping” sclerotic appearance on imaging, the most likely diagnosis is:

Melorheostosis (Leri’s disease)

The primary basis for this diagnosis includes:

• Imaging Findings: Wavy, localized sclerosis along the long axis of the bone, resembling “dripping wax.”
• Clinical Features: A young patient with progressively worsening pain and a localized distribution.
• Pathogenesis: A rare benign bone proliferative disorder, consistent with typical literature descriptions.

IV. Treatment Plan and Rehabilitation

Since Melorheostosis is a benign bone overgrowth disease, the main treatment objectives are to alleviate symptoms and maintain joint function. Recommended strategies include:

1. Conservative Treatment:
   • For mild pain, analgesics (such as NSAIDs) may be used to relieve symptoms.
   • Under the guidance of rehabilitation or orthopedic specialists, physical therapy and functional exercises can help improve joint mobility and reduce stiffness.
2. Surgical Intervention:
   • In cases where local overgrowth severely impairs joint function or leads to deformity, surgical decompression or corrective procedures may be considered.
   • If significant nerve or vascular involvement is present, decompression surgery may be evaluated by professionals.
3. Rehabilitation Training Recommendations (FITT-VP Principle):
   • Frequency: 3–5 sessions per week, gradually adjusted based on symptoms and fatigue.
   • Intensity: Begin with low to moderate intensity (e.g., low-resistance, low-load exercises), increasing progressively.
   • Time: 15–30 minutes per session initially, gradually extending to 30–45 minutes based on tolerance.
   • Type: Include range-of-motion exercises (active or passive stretching), strength training (resistance bands or light weights), balance activities, and aerobic exercise (such as stationary cycling if lower limbs are stable).
   • Progression: Increase resistance and duration as pain subsides and joint mobility improves.
   • Volume & Pattern: Adjust specific exercises under the guidance of an orthopedic physician or rehabilitation therapist, dividing them into sets as necessary.

   During exercise, closely monitor for pain, swelling, or local discomfort. If symptoms worsen considerably, seek medical advice promptly and adjust the plan.

Important Note: Due to uneven bone sclerosis, special attention should be given to localized stress on joints and cortical areas during weight-bearing or resistance exercises to avoid stress fractures or related injuries.

Disclaimer: This report is intended for reference only and cannot replace in-person consultation or professional medical advice. For specific diagnosis and treatment, please consult an orthopedic or related specialist.