Simon Richards

orthopaedic surgeon


your Specialist in conditions


of the arm & hand


Steroid Injections

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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).

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)

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.