Another examination for recognition of neuropathy is the pinprick test. Thus far we have looked at the 10-gm monofilament test and the 128 Hz tuning fork test. The pinprick test is yet another valuable, cheap and easy test to perform to assess neurologic function or dysfunction in the diabetic foot. Much like the other tests discussed the lack of pinprick sensation is associated with and increased risk of ulceration (1).

The Technique

1. The test should be performed with a disposable pin

2. Apply the pin to the dorsal surface of the hallux just proximal to the nail

3. Apply just enough pressure to deform the skin, and with the patient keeping their eyes closed assess for pinprick awareness

4. Inability to perceive the pinprick is considered an abnormal result.

Video demonstration

1. Abbott, C. A., Carrington, A. L., Ashe, H., Bath, S., Every, L. C., Griffiths, J., Hann, A. W., Hussein, A., Jackson, N., Johnson, K. E., Ryder, C. H., Torkington, R., Van Ross, E. R. E., Whalley, A. M., Widdows, P., Williamson, S. and Boulton, A. J. M. (2002), The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. Diabetic Medicine, 19: 377–384. doi: 10.1046/j.1464-5491.2002.00698.