Teaching Points
- Once Cushings Syndrome is confirmed biochemically, further imaging is dictated by the ACTH
- ACTH suppressed – Likely primary adrenocortical lesion and CT scan of the adrenals is required
- ACTH normal or high – Either pituitary disease or ectopic source of ACTH. Further biochemical testing with dexamethasone suppression may help differentiate the two causes prior to imaging
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