Recurrent femoral neck fractures: keep an eye out for Cushing�s syndrome
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Date
2024
Authors
Journal Title
BMJ Case Reports
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Abstract
Prolonged glucocorticoid overexposure leads to Cushing�s syndrome (CS). It is characterised by diverse metabolic, cardiovascular and bone mineral manifestations. A middle-aged woman presented for a preoperative evaluation of a pathological fracture of the left neck of the femur. She had a history of a hip fracture on the opposite side 3 years back. She exhibited several features specific to CS and was subsequently diagnosed with Cushing�s disease. She underwent transsphenoidal adenoma resection and achieved remission. Glucocorticoids primarily affect the trabecular bone compared with cortical bones, and vertebral fractures are common in CS. The femoral neck consists of both trabecular and cortical bone and can be involved in CS. Our patient was not diagnosed as C at the first pathological fracture and was subsequently diagnosed only after the second fracture. This case report underscores the importance of a diligent search for a possible endocrinological aetiology in any case of pathological fractures. Copyright 2023 BMJ Publishing Group. All rights reserved.
Description
Keywords
Endocrine system, Fracture Fixation, Intramedullary, Neuroimaging, Pituitary disorders, Radiology (diagnostics)