best diagnosis of chushing - ninila

[ArchivalUser]

HI EVERYONE

I HAVE A QUESTION?
FOR THE BOARDS WHATS THE BEST WAY TO GO ABOUT CUSHINGS?
1. LOW DOSE DEXO.....THEN 24 HOUR URINE CORTISOL....THEN HIGH DOSE DEXO SUPRESSION TEST
OR
2. 24 HOUR URINE CORTISOL...THEN HIGH DOSE DEXO SUPPRESION TEST

[ArchivalUser]

1
low dose for comparitively rapid screening.
24hr urine cortisol for confirming
High does dexa to know the site/cause (adrenal tumor Vs. cushing/ectopic ACTH/factitious) and go on with ACTH level then further localise with imaging.

[ArchivalUser]

Thank you very much for you help nizan