An acute fracture in the region to be adjusted is a contraindication.

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An acute fracture in the region to be adjusted is a contraindication because the forces used in adjustments can disrupt fracture healing, displace fragments, and worsen pain. In the acute phase the bone is unstable and local tissues are inflamed, so applying a thrust or pressure could worsen the injury. Therefore avoid adjusting that region and refer for medical evaluation, with management focusing on immobilization and symptom control. Imaging results don’t rule out fracture; an acute fracture can be occult on X-ray, so a negative image does not guarantee safety. This makes the statement true; the other options don’t fit because they imply it’s safe under some circumstances or rely on imaging alone.