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Cushing's Syndrome Diagnosis

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Table 1. Overlapping Conditions and Clinical Features of Cushing's Syndrome a Symptoms Signs Overlapping conditions Cushing's syndrome features in the general population that are common and/or less discriminatory • Depression • Fatigue • Weight gain • Back pain • Changes in appetite • Decreased concentration • Decreased libido • Impaired memory (especially short term) • Insomnia • Irritability • Menstrual abnormalities • Dorsocervical fat pad ("buffalo hump") • Facial fullness • Obesity • Supraclavicular fullness • Thin skin b • Peripheral edema • Acne • Hirsutism or female balding • Poor skin healing • Hypertension b • Incidental adrenal mass • Vertebral osteoporosis b • Polycystic ovary syndrome • Type 2 diabetes b • Hypokalemia • Kidney stones • Unusual infections • In children, slow growth • In children, abnormal genital virilization • In children, short stature • In children, pseudoprecocious puberty or delayed puberty Features that best discriminate Cushing's syndrome; most do not have a high sensitivity • Easy bruising • Facial plethora • Proximal myopathy (or proximal muscle weakness) • Striae (especially if reddish purple and >1 cm wide) • In children, weight gain with decreasing growth velocity a Features are listed in random order. b Cushing's syndrome is more likely if onset of the feature is at a younger age.

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