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    • #65901
      Colm McCarthy
      Participant

      Hi Stephen, any practical tips for performing a PIN steroid/LA injection for PIN syndrome? Thanks!

    • #65907
      Stephen Bird
      Keymaster

      Absolutely,

      Sit the patient opposite you and place their hand on the bed with their elbow flexed 45 degrees.

      Scan the radius in short axis and you can see the supinator muscle wrapped around it.

      You will see the PIN (or whatever you want to call it !!) in the middle of the supinator flesh between the two heads.

      Follow the PIN in short axis and wait until you see it leave the supinator.

      This is the injection site.

      You can play around with a bit of wrist supination and pronation to fine tune the location of the PIN into a place that you find most optimal.

      Once you have the PIN identified at the point it is entering the supinator you can inject in this plane using the brachioradialis muscle as a path.

      The only structure you need to be careful of is the recurrent radial artery (Leash of Henry). This artery is usually near by and can be a bit of a nuisance.

      Inject adjacent to the nerve without getting the bevel too close.

      Steve.

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