| Incidental findings | Rheumatoid arthritis, scratch marks (PBC) |
| Signs | Bruising, central obesity, moon-like facies, abdominal striae, proximal myopathy. |
| Differential diagnosis | Cushings syndrome/disease |
| Tests |
U&E, glucose
24h urinary free cortisol Low dose dexamethasome supression - failure of supression High dose dexamethasome supression - supresses with pituitary tumour but not adrenal/ectopic tumours Plasma ACTH +/- MR pit fossa +/- Inferior petrosal sinus sampling |