E24.0 Pituitary-dependent Cushing disease
E24.2 Drug-induced Cushing syndrome
E24.3 Ectopic ACTH syndrome
E24.8 Other Cushing syndrome
E24.9 Cushing syndrome, unspecified
4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Connective Tissue Dysfunction1
4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation
6B: Impaired Aerobic Capacity/Endurance Associated with Deconditioning
7B: Impaired Integumentary Integrity Associated with Superficial Skin Involvement
PREFERRED PRACTICE PATTERN
Typical findings in Cushing syndrome. (From McPhee SJ, Hammer GD. Pathophysiology of Disease: An Introduction to Clinical Medicine. 6th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
Clinical features of Cushing syndrome. A. Note central obesity and broad, purple stretch marks (B close-up). C. Note thin and brittle skin in an elderly patient with Cushing. D. Hyperpigmentation of the knuckles in a patient with ectopic ACTH excess. (From Longo DL, Fauci A, Kasper D, et al., eds. Harrison’s Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2012.)
A 38-year-old female who works as a certified nurse assistant in a nursing home arrived complaining of upper and lower back pain which started 3 years ago after transferring a patient from wheelchair to bed. Patient reports that she has been suffering from back pain since then for which she has received all kinds of conservative treatment, including prior physical therapy for which she specifies hot packs and massage about 8 months ago. She reports having received multiple corticosteroids injections as well as oral corticosteroids for multiple periods of time prescribed by different physicians for pain control. The past medical history includes hypertension. Patient denies any history of osteoporosis and has never received a bone density test. In addition, patient reported that she feels very depressed because she has been unable to get pregnant. Upon observation, patient appears with central obesity and thin extremities (all four), kyphotic posture, thick neck, and round moon like face. During examination, ...
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