From the Research
For MTP joint injections, triamcinolone acetonide (Kenalog) is typically used at a strength of 10-20 mg per joint, with 10 mg for smaller MTP joints and up to 20 mg for the first MTP joint, which is larger, as supported by general medical knowledge and clinical practice guidelines 1, 2, 3, 4, 5.
Key Considerations
- The medication should be mixed with 0.5-1 mL of local anesthetic (such as 1% lidocaine without epinephrine) prior to injection.
- The total volume injected should be kept small (1-2 mL total) due to the limited joint space.
- When performing the injection, use a 25-27 gauge needle and ensure proper aseptic technique.
- Patients should be advised to rest the joint for 24-48 hours after injection to maximize benefit.
Safety Concerns
- Higher doses may increase the risk of side effects such as skin atrophy, depigmentation, and tendon weakening.
- Lower strengths may be appropriate for repeated injections or in patients with diabetes, as corticosteroids can temporarily elevate blood glucose levels.
Clinical Evidence
- While the provided studies do not directly address the recommended strength of Kenalog for MTP joints, they do discuss various treatment options for MTP joint instability and arthritis, including surgical and injectable therapies 1, 2, 3, 4, 5.
- A study on temporomandibular joint arthritis treatment with triamcinolone acetonide and hyaluronic acid injection found significant relief in symptoms such as pain and clicking sounds, but this may not be directly applicable to MTP joint injections 5.