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ICD-9-CM Codes

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  • 255.0 Cushing syndrome

  • 255.3 Other corticoadrenal overactivity

  • 255.6 Medulloadrenal hyperfunction

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ICD-10-CM Codes

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  • E24.0 Pituitary-dependent Cushing disease

  • E24.2 Drug-induced Cushing syndrome

  • E24.3 Ectopic adrenocorticotropic hormone (ACTH) syndrome

  • E24.8 Other Cushing syndrome

  • E24.9 Cushing syndrome, unspecified

  • E27.5 Adrenomedullary hyperfunction

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Preferred Practice Patterns

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Associated Physical Therapy Diagnoses

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  • 315.4 Coordination disorder

  • 718.45 Contracture of joint, pelvic region, and thigh

  • 719.70 Difficulty in walking involving joint site unspecified

  • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

  • 728.89 Disorders of muscle, ligament, and fascia

  • 729.9 Other and unspecified disorders of soft tissue

  • 780.7 Malaise and fatigue

  • 781.2 Abnormality of gait

  • 782.3 Edema

  • 786.0 Dyspnea and respiratory abnormalities

  • 786.05 Shortness of breath

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Key Features

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Description

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  • Excessive production and release of adrenal hormones, glucocorticoids (cortisol), androgens, and mineralocorticoids from the adrenal glands

  • Adrenal glands critical in regulating inflammation and cardiovascular function

  • Insidious or sudden onset

  • High cortisol levels

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Essentials of Diagnosis

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  • Fatigue

  • Weight gain

  • Decreased activity tolerance

  • Hypertension

  • Confirmation of suspected disease through blood testing

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General Considerations

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  • Diagnosis for more occult problems may take time and require intensive diagnostic testing.

  • May cause or be caused by pathology in multiple organ systems.

    • - Cardiovascular: heart, peripheral circulation, blood pressure

    • - Integumentary

  • May result in secondary problems needing physical therapy intervention depending on severity such as aerobic capacity/muscle endurance impairment, weakness/impaired muscle performance, musculoskeletal problems, neuromuscular problems, weight gain.

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Demographics

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  • Males and females equally affected

  • Can develop at any age

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Clinical Findings

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Signs and Symptoms

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  • Fatigue

  • Weight loss or gain

  • Libido changes

  • Pallor

  • Flushed face

  • Chest pain

  • Rapid breathing

  • Tachycardia

  • Palpitations

  • Hypertension

  • Excessive thirst

  • Sweating

  • Increased heat sensitivity

  • Headaches

  • Decreased gastrointestinal (GI) motility

  • Tingling

  • Increased or decreased muscle bulk

  • Muscle weakness

  • Paralysis

  • Increased frequency of urination

  • Increased bowel frequency

  • Darkening/hyperpigmentation of skin

  • Stretch marks

  • Acne

  • Hyperglycemia or diabetes

  • Inability to absorb calcium

  • Water retention, edema

  • Thinning of skin

  • Easy bruising

  • Poor wound healing

  • Abdominal pain

  • Diarrhea

  • Vomiting

  • Nausea

  • Depression, irritability, personality changes

  • Tremors

  • Low-back pain in area of kidneys

  • Hypokalemia

  • Increased sodium levels

  • Hallucinations

  • Amenorrhea, menstrual irregularities

  • Reduced uterus or breast size

  • Infertility

  • Increased body or facial hair

  • Deepened voice

  • Baldness

  • Growth deficiency, short stature

  • Round face, moon face

  • Increased excess body fat in trunk and thoracic back

  • Osteoporosis

  • Increased infection risk

  • Kidney stones

  • Goiter

  • Sleep disturbances

  • Cushing syndrome

  • Adrenal crisis

    • - Coma

    • - ...

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