Doctor, based on these images, do I need surgery?

This is a very common question in clinical practice. Many patients turn to online support groups or send their imaging scans to doctors, asking whether a conclusion like this is severe and if surgery is required. Then, people give conflicting advice, leading to confusion and not knowing what to do.

If surgery could be indicated based solely on imaging results, doctors clearly wouldn't need to spend more than 10 years in training.

In reality, deciding to operate on a patient and, furthermore, performing that surgery is not that simple.

Photo: Dr. Vu Anh during a patient's surgery

First, a physical examination is necessary. Every joint pathology, injury, or sports medicine condition has specific clinical tests to assess that lesion. As a doctor examines and operates more, they gain increasing experience in clinical evaluation.

Second, imaging modalities (X-ray, CT, MRI) have their own sensitivity and specificity; simply put, there is a margin of error. Correlating imaging findings with clinical examination is a crucial factor in deciding on surgery.

Third, the proposed surgical plan for each patient will also differ due to numerous factors such as age, occupation, daily living and athletic demands, underlying medical conditions, expectations, determination to undergo treatment, financial status, etc. This means that the same lesion may be treated with different approaches rather than applying a rigid, one-size-fits-all indication for every patient.

Fourth, once surgery is agreed upon, the patient also needs to be counseled on potential risks and possible complications before the procedure is performed.

Of course, in some cases where the imaging findings are extremely clear, the doctor might answer that surgery is likely necessary, but the patient must still be examined because there could be other associated injuries or contraindications for surgery.

Therefore, given all the factors above, if you have a health issue, please consult a doctor directly.

Magnetic resonance imaging results cannot replace a physical examination, and the same lesion does not mean the same treatment.