What imaging findings would warrant referral rather than adjustment of a limb?

• A. Mild soft tissue swelling
• B. Normal X-ray
• C. Fracture lines, dislocations, aggressive bone lesions, suspected infection or neoplasia near the joint
• D. No imaging needed

Answer: (C)

When imaging shows signs of a fracture, a dislocation, aggressive bone lesions, or suspected infection or neoplasia near a joint, these are red flags that point to structural instability or serious disease. Manipulating a limb under these conditions risks worsening a fracture, displacing a joint, spreading infection, or delaying essential medical treatment. Such findings warrant controlled medical evaluation, imaging, and often referral to orthopedic or other specialists for definitive care.

In contrast, mild soft tissue swelling or a normal X‑ray suggests there isn’t an obvious fracture or destructive joint pathology at that moment, so a chiropractic approach can be considered with appropriate clinical judgment and without automatically requiring referral. No imaging needed isn’t a separate condition you’d treat with adjustment when red flags are present.