Unmasking Cushing’s Syndrome: Key Diagnostic Investigations Explained

Unmasking Cushing’s Syndrome: Key Diagnostic Investigations Explained

Question. Write a short note on investigations in a case of Cushing’s syndrome.

Answer. The excessive production of cortisol causes Cushing’s syndrome.

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Investigations Of Cushing’s Syndrome

• Urinary excretion of 11-oxysteroids and 17-ketosteroids is increased.
  Dexamethasone suppression test showing failure of significant plasma cortisol suppression favors an adrenal tumor as the cause.
• Glucose tolerance tests such as diabetes.
• X­ray chest for evidence of thymic carcinoma.
• X­ray skull for pituitary edema is not helpful since a pituitary basophilic adenoma does not expand, and so the sella turcica and glenoid processes are normal.
• X­ray dorsal spine may show the collapse of vertebrae, producing a fish spine appearance.
• IV *pyelography for adrenocortical tumor. *Perirenal insufflation, *tomography, USG and CT scan, and MRI to detect adrenal hyperplasia.

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