Corticosteroids effects can be divided into Glucocorticoid and Mineralcorticoid activity. It’s the Glucocorticoids which have the anti-inflammatory effect. In my Practice, I use Triamcinolone (Kenalog) because:-

  • More flexibility in dosage
  • More soluble in local anaesthetics
  • Less pain after injection

However Methylprednisolone (Depomedrone) is perfectly suitable to use as well (double the dose when compared to Kenalog).

Side-Effects
Arise when:-

  • Too large a dose is used
  • Inappropriate drug is used
  • Injections given too frequently
  • Poor injection technique

Systemic Effects

  • Flushing
  • Menstrual irregularity
  • Glucose intolerance

Local Effects

  • Post injection flare (unavoidable)
  • Infection
  • Skin atrophy, depigmentation and discolouration, tendon  rupture (Poor technique)

Dosages
This is a summary of the dosages I use for specific joints. I also incorporate/mix some local anaesthetic, usually 0.5% Marcaine, within the syringe to make up the final volume.

 Joint Volume (ml)   Kenalog (mg)
 Shoulder  10 40
 Hip 10 40
 Knee 10 40
 Elbow  5 20
 Ankle 5 20
 Fingers 1 10-20
 Wrist, Thumb 2 10-20

Please see conditions listed in the menu above for advice on how to inject specific anatomical areas.

           
Please note: any information on this web site relates solely to my clinical practice. The views and management of other surgeons may differ.