Passage / Scenario

Antoinette is 47-year-old woman with history of hypertension presented to ER with complain of sudden pain in her heel. Her lifestyle is sedentary and denies history of trauma or rigorous physical exertion. On admission assessment, spontaneous rupture of the Achilles tendon was diagnosed and treatment was initiated. Few weeks following her ER visit, Antoinette sought the help of a family physician for prescription of pain medication. Her physical assessment showed central obesity, thin musculature, and abdominal striae. Cushing's syndrome was suspected. Further endocrine assessment showed clinical features typical of Cushing's syndrome, which had been present for at least four years.