Before manipulating a joint injury, which criteria should be present?

The correct choice highlights that marked angulation and distal limb pulselessness are critical indicators that warrant careful assessment before you manipulate a joint injury. Marked angulation typically suggests a significant injury, such as a dislocation or a fracture affecting the joint. Additionally, distal limb pulselessness can indicate compromised circulation, which might lead to serious complications if manipulation occurs without addressing these symptoms.

Injuries presenting with these signs take precedence because they indicate potential vascular compromise or severe mechanical instability, both of which require immediate and careful intervention. This scenario underscores the importance of stabilizing the injury and ensuring the patient’s circulation is adequate before any movement.

The other choices involve symptoms that, while indicative of injury severity, do not provide the urgency required to avoid potentially harming the patient further. For example, swelling and redness may be present in less severe injuries and do not necessarily necessitate or justify immediate manipulation. Similarly, obvious fractures and alertness may not indicate readiness for manipulation, as the underlying soft tissue and circulatory integrity need consideration. Finally, pain and the ability to move the joint also do not sufficiently address the risk of further injury.