What skeletal abnormalities are patients with Cushing syndrome prone to?

Patients with Cushing syndrome are particularly susceptible to both osteoporosis and osteonecrosis of the femoral head due to the effects of excess cortisol. Cushing syndrome leads to hypercortisolism, which has several direct and indirect effects on bone health.

Excessive cortisol negatively impacts bone metabolism by inhibiting osteoblast function—cells responsible for bone formation. This inhibition results in decreased bone density, contributing to the development of osteoporosis, characterized by fragile bones and an increased risk of fractures.

In addition, cortisol affects the blood supply to the bones, particularly in the femoral head. This can lead to osteonecrosis, a condition where bone tissue dies due to a lack of blood flow. The combination of these two skeletal conditions underscores the increased risk Cushing syndrome patients face regarding skeletal complications.

Both osteoporosis and osteonecrosis are significant concerns in the management of patients with Cushing syndrome, highlighting the need for monitoring and potential intervention to prevent these skeletal abnormalities.