{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:41:12Z","timestamp":1777448472719,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:p>A wide range of clinical presentations for Cushing\u2019s syndrome has been described in the literature. Avascular necrosis of femur is a well-recognized complication of excessive glucocorticoid administration, but its occurrence due to endogenous hypercortisolism is rare. We present the case of a 47-year-old male who presented to us with severe low backache, hypertension, uncontrolled diabetes, and other signs and symptoms of Cushing\u2019s syndrome. Hormonal evaluation confirmed hypercortisolism, and a contrast-enhanced computed tomography of the abdomen localized the lesion in the left adrenal gland. Assessment of the severe low back ache\u2014the main symptom for which the patient came to us\u2014by magnetic resonance imaging of the spine and pelvis revealed avascular necrosis of bilateral femoral heads. Resection of the left adrenal gland revealed an adrenocortical carcinoma. To the best of our knowledge, this is only the second case where an adrenocortical cancer leading to hypercortisolism is the cause of avascular necrosis of hip.<\/jats:p>","DOI":"10.1177\/00031348221129510","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T04:55:31Z","timestamp":1663822531000},"page":"2701-2704","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Avascular Necrosis of Femur as a Complication of Cushing\u2019s Syndrome Due to Adrenocortical Carcinoma"],"prefix":"10.1177","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8765-4140","authenticated-orcid":false,"given":"Atul","family":"Anand","sequence":"first","affiliation":[{"name":"Department of General Surgery, All India Institute of Medical Sciences, Patna, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandan 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