Larger Joints (Shoulder or Knee)
Inject 5 ml lidocaine (Xylocaine) + 1 ml of triamcinolone acetonide 40mg/ml (Kenalog) using a 1.5-inch, 21 gauge needle.
Note: For the knee, you may go up to 2ml or 80 mg Kenalog.
Ankle joint
Inject 3 to 5 ml lidocaine (Xylocaine) + 0.5 ml to 1 ml of triamcinolone acetonide 40mg/ml (Kenalog) using a 1 to 1.5-inch, 23 gauge needle.
Smaller joints (Elbow, wrist)
Elbow: Inject 3 ml lidocaine (Xylocaine) + 0.5 ml of triamcinolone acetonide 40mg/ml (Kenalog) using a 1.0-inch, 23 gauge needle.
Wrist: Inject 3 ml lidocaine (Xylocaine) + 0.5 to 1 ml of triamcinolone acetonide 40mg/ml (Kenalog) using a 0.5 to 1.5-inch, 21 or 25 gauge needle.
Note, triamcinolone and methylprednisolone acetate (Depo-Medrol) have the same equivalent doses for steroid conversion, so their doses are about the same.