Figure 1.
Suggested algorithm for investigation and management of suspected Cushing's syndrome during COVID-19 pandemic. ONDST: overnight dexamethasone suppression test; UFC: urinary free cortisol; ACC: adrenocortical cancer. 1The higher the UFC or post-dexamethasone serum cortisol the greater the confidence that the patient has Cushing's syndrome; 2MRI or CT pituitary if clear visual field defects to identify sight-threatening macroadenoma – CT head with coronal reconstructions can be included in the body CT to minimise need for extra imaging.