title: [Hormone-induced spontaneous femoral neck fracture in a 28-year-old female patient].
abstract: METHODS
  A 28-year-old woman was referred to hospital with a spontaneous femoral neck fracture. Dual energy X-ray absorptiometry showed severe osteoporosis without apparent cause or risk factors. The basic endocrinologic evaluation revealed hypercortisolism, and the diagnosis of Cushing's disease could be made following biochemical test and magnetic resonance imaging. A transsphenoidal resection of the pituitary gland tumor was performed and led to a cure of the disease. The patient received calcium and vitamin D substitution as well as biphosphonates.
  
  
  CONCLUSIONS
  Glucocorticoid-induced osteoporosis is the most frequent cause of secondary osteoporosis. Only few cases with occult endogenous Cushing's syndrome and osteoporosis as the main manifestation of the disease have been reported. Nevertheless, hypercortisolism should be excluded whenever osteoporosis without apparent cause is diagnosed.
authors.affiliation: Margarita Bala, Cornelius Bollheimer, Jürgen Schölmerich, Andreas Schäffler.
authors.forename: Margarita
authors.initials: M
authors.lastname: Bala
authors.forename: Cornelius
authors.initials: C
authors.lastname: Bollheimer
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schölmerich
authors.forename: Andreas
authors.initials: A
authors.lastname: Schäffler