This article makes a compelling case for the responsible use of X-rays in chiropractic care, especially for patients over 50, championing the motto, "See Before You Adjust." The author warns against the dangerous assumption that significant spinal pathologies, such as vertebral compression fractures, always present with clear red flags. In reality, many of these fractures are "silent," occurring with minimal or no memorable trauma and are often misattributed to aging or muscle strain. Research confirms that these fractures are prevalent and frequently underdiagnosed, even in patients who don't meet the criteria for osteoporosis. Relying solely on a patient's symptoms and physical exam is insufficient and risky; applying a spinal adjustment to an unrecognized fracture could have serious consequences. The author argues that for the aging population, radiographs are not a form of defensive medicine but an essential component of informed, responsible patient care. Imaging provides invaluable information about structural integrity that cannot be obtained otherwise, helping to determine if an adjustment is safe, which techniques are appropriate, and whether a referral is necessary. Understanding the state of the musculoskeletal system before applying a mechanical force is a fundamental principle of patient safety.