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Multiple Metatarsal Fractures: The First Manifestation of Cushing's Disease—A Case Report

Vilim Molnar MD, Paulo Zekan MD, Tina Dušek MD, PhD, and Alan Ivković MD, PhD
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Cushing's syndrome is an uncommon clinical condition most frequently presenting with central obesity, facial rounding, proximal muscle weakness, and skin thinning. The objective of this case report is to highlight an unusual presentation of Cushing's syndrome. A 35-year-old woman presented to the orthopedic clinic with a 1-year history of foot pain without any history of trauma. Radiography of the foot showed multiple metatarsal fractures. Evaluation for secondary causes of reduced bone strength revealed that the patient had Cushing's disease, although other typical signs and symptoms were not remarkable. It can be concluded that Cushing's syndrome should always be included in the differential diagnosis of foot fracture without any evidence of trauma.

University of Zagreb School of Medicine, Zagreb, Croatia. Dr. Molnar is now with St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia. Dr. Zekan is now with Department of Gynaecology and Obstetrics, University Hospital “Sveti Duh,” Zagreb, Croatia.

Unit for Endocrinology, Department of Internal Medicine, Clinical Hospital Centre Zagreb, Croatia.

Department of Orthopaedic Surgery, University Hospital “Sveti Duh,” Zagreb, Croatia.

Corresponding author: Paulo Zekan, University of Zagreb School of Medicine, Rudera Boskovica 9, Split, 21000 Croatia. (E-mail: paulo.zekan@gmail.com)