What is the strength of Kenalog (Triamcinolone) for Metacarpophalangeal (MCP) joints?

From the Guidelines

For Metacarpophalangeal (MCP) joint injections, Kenalog (triamcinolone acetonide) is typically used at a strength of 10-20 mg per joint. The standard approach is to use 10 mg for smaller MCP joints and up to 20 mg for larger or more severely inflamed joints. This dosing is based on general clinical practice guidelines, although specific studies on the optimal dosing for MCP joints are limited. The medication should be administered using a 25-27 gauge needle with proper sterile technique. The total volume injected typically ranges from 0.5 to 1 mL, often mixed with a local anesthetic such as 1% lidocaine to provide immediate pain relief. Patients should be advised to rest the joint for 24-48 hours after injection and monitor for any signs of infection or skin changes. This dosing is effective because it provides sufficient anti-inflammatory effect to reduce synovitis and pain while minimizing systemic absorption and potential side effects such as skin atrophy or tendon weakening. The duration of effect typically lasts 6-12 weeks, though this varies based on the severity of inflammation and individual patient factors 1.

Key Considerations

• The use of intra-articular corticosteroids like Kenalog is supported by evidence for short-term pain relief in osteoarthritis, including hand OA 1.
• The choice of dose and volume should be individualized based on the size of the joint and the severity of inflammation.
• Proper technique and sterile precautions are essential to minimize the risk of infection or other complications.
• Patients should be monitored for potential side effects and advised on post-injection care to optimize outcomes.

Clinical Evidence

While the provided evidence does not specifically address the dosing of Kenalog for MCP joints, it discusses the use of intra-articular corticosteroids for osteoarthritis, including hand OA. The effectiveness of corticosteroids for pain relief in OA is supported by the evidence 1, although the optimal dosing and duration of effect can vary based on individual patient factors and the specific joint involved.

From the FDA Drug Label

KENALOG-40 40 mg per 10 mL Injectable Suspension KENALOG®-40(triamcinolone acetonide injectable suspension, USP)40 mg per mL KENALOG® -40(triamcinolone acetonide injectable suspension, USP)200 mg per 5 mL(40 mg/mL) KENALOG®-40(triamcinolone acetonide injectable suspension, USP)400 mg per 10 mL(40 mg/mL) KENALOG® -80(triamcinolone acetonide injectable suspension, USP)80 mg per mL KENALOG®-80(triamcinolone acetonide injectable suspension, USP)400 mg per 5 mL(80 mg/mL)

The strength of Kenalog (Triamcinolone) for intra-articular use, including Metacarpophalangeal (MCP) joints, is available in two concentrations:

• 40 mg/mL (KENALOG-40)
• 80 mg/mL (KENALOG-80) 2

From the Research

Strength of Kenalog (Triamcinolone) for Metacarpophalangeal (MCP) Joints

• The provided studies do not directly address the strength of Kenalog (Triamcinolone) for Metacarpophalangeal (MCP) joints.
• However, the studies provide information on the use of Triamcinolone acetonide in other joints, such as the temporomandibular joint (TMJ) and the knee.
• In the study 3, 40 mg of triamcinolone acetonide was used to treat TMJ arthritis.
• In the study 4, 40 mg of triamcinolone acetonide was used as a single intra-articular injection for knee osteoarthritis.
• In the study 5, 40 mg of triamcinolone acetonide (Kenalog®) was used as an intra-articular injection for knee osteoarthritis.
• The strength of Kenalog (Triamcinolone) used in these studies was 40 mg, but it is not clear if this is the appropriate strength for MCP joints.
• More research is needed to determine the appropriate strength of Kenalog (Triamcinolone) for MCP joints, as the provided studies do not provide sufficient information on this topic 3, 4, 5.