 In this video, we are going to demonstrate the technique of fine needle aspirate. Fine needle aspirate can be obtained from a patient with a nodal plaque or the edematos form of buruli ulcer. It may also be indicated when an ulcer is not undermined. In these situations, fine needle aspirate is the technique of choice. This patient with a plaque on the right wrist agrees to have a fine needle aspirate done. The area of the plaque is as shown. For this procedure, you need to put on a pair of sterile gloves. You need to assemble alcohol swabs or alcohol soaked gauze, a 21 gauge needle, and you need a few dry swabs. In addition, you need tubes with transport medium already prepared from the laboratory. Now disinfect the site with alcohol. Be careful to disinfect the whole site with alcohol moving from the center of the lesion outward. Identify the sites that you are going to insert your needle. This is usually the center of a nodal and in the case of an edematos form of buruli ulcer, it may be a weak point in the lesion. In the case of a nodal or a small plaque, stabilize the lesion with your left hand and insert your needle into the estimated center of the lesion, moving three times in different directions without withdrawing the needle through the skin. Finally, withdraw the needle from the skin and rinse the contents in the transport medium that has been supplied by the laboratory. Now remember to label your sample. Write the name, the age, the sex, and the date the sample was taken on the label. Before storing it away or transporting it to the laboratory. To increase the likelihood of getting a positive result, take a second FNA sample. This 50-year-old farmer presented with a plaque on the right lower limb. This plaque had just started ulcerating but wasn't undermined. I identified two weak points on the lesion for fine needle aspiration. The site of the lesion was disinfected with alcohol as done in the previous case, starting from the center of the lesion and moving outward. The already prepared 21 gauge needle and syringe was inserted at the weak points that had been identified. Moving in three different directions, applying suction each time. The specimen was handled as previously described. This patient presented with a lesion that looked like brulee ulcer and had been operated on previously and this lesion had ulcerated again. A sample needs to be obtained. In this case, the lesion wasn't undermined. An attempt to obtain a good swab specimen was impossible because the lesion was not undermined. A fine needle aspirate was obtained from the edge of the lesion. This was done as previously described. Moving the needle in three different directions back and forth. After withdrawing the needle, the content was flushed in transport medium supplied by the laboratory. So, in summary, to perform a fine needle aspirate, you need to explain the procedure to the patient. Identify the site of the lesion and then disinfect the area with an alcohol swab. Get your needle 21 gauge needle with a syringe attached to it. The syringe can be a 2 mil, 5 mil or 10 mil syringe. Insert your needle right in the estimated middle of the lesion and then move back and forth three times in different directions. Take out your needle and flush the contents in the fluid or transport medium provided by the laboratory. Cover the tube and label the tube with the name, the age, the sex and the dates the sample was taken. Store it away in a cool place until you are ready to send it to the laboratory. In this way, you will be able to send a good sample to the laboratory and thereby receive accurate confirmation of the clinical diagnosis you have made.