Cushing’s Syndrome
Clinical abnormalities associated with excess cortisol in the body. It can result from excess adrenal cortisol production or long-term corticosteroid medication use.
Demographics:
In physical therapy, this condition is seen in patients who have received large doses of corticosteroid medications.
Clinical Presentation:
• Hypertensio
• Round, full face, “moon face”
• red-purple abdominal striae, can also appear on the thigh or breast
• Thin skin with eccymoses, acne, and poor wound healing
• Back pain
• bone pain or tenderness
• collection of fat between the shoulders, “buffalo hump”
• Muscle wasting with proximal muscle pain
• Hirsutism
• Menstrual irregularities
Differential Diagnosis
• Alcoholism-can cause pseudo-Cushing’s syndrome from cortisol overproduction
• Obesity associated with diabetes mellitus
• Adrenogenital syndrome
Clinical Bottom Line: Refer
If the patient presents with signs and symptoms of endocrine involvement, he or she should be referred to a physician for further examination and laboratory testing. Treatment for these patients depends on the cause of the symptoms. For example, if a pituitary tumor is the cause of excess hormone secretion, the tumor is removed; if glucocorticoid therapy is the cause, medication use will be slowly discontinued. Neither of these interventions are within the scope of physical therapy practice.
References:
Please refer to “Cushing’s Syndrome” on the reference list.
Demographics:
In physical therapy, this condition is seen in patients who have received large doses of corticosteroid medications.
Clinical Presentation:
• Hypertensio
• Round, full face, “moon face”
• red-purple abdominal striae, can also appear on the thigh or breast
• Thin skin with eccymoses, acne, and poor wound healing
• Back pain
• bone pain or tenderness
• collection of fat between the shoulders, “buffalo hump”
• Muscle wasting with proximal muscle pain
• Hirsutism
• Menstrual irregularities
Differential Diagnosis
• Alcoholism-can cause pseudo-Cushing’s syndrome from cortisol overproduction
• Obesity associated with diabetes mellitus
• Adrenogenital syndrome
Clinical Bottom Line: Refer
If the patient presents with signs and symptoms of endocrine involvement, he or she should be referred to a physician for further examination and laboratory testing. Treatment for these patients depends on the cause of the symptoms. For example, if a pituitary tumor is the cause of excess hormone secretion, the tumor is removed; if glucocorticoid therapy is the cause, medication use will be slowly discontinued. Neither of these interventions are within the scope of physical therapy practice.
References:
Please refer to “Cushing’s Syndrome” on the reference list.