PMC8666499_01
(A) Generalized acne on the patient's face; (B) Wide purplish striae on the patient's abdomen.
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She was investigated for Cushing's syndrome as she had facial acne, purplish abdominal striae, skin thinning and easy bruising (Figure 1).
Serial chest radiographs showing acute pulmonary oedema from her previous 4 admissions. (A) left pleural effusion with bat's wings appearance and cardiomegaly; (B) left pleural effusion with cardiomegaly; (C) upper lobe diversion with bat's wings appearance and cardiomegaly; (D) left pleural effusion.
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At 27 weeks of gestation, she was readmitted for acute pulmonary oedema (Figure 2) with hypertensive crisis.
(A) Lateral view of thoracolumbar X-ray showing the compression fracture at T9 to L1 spine with osteopenic bone; (B) Volumetric 3D reconstruction of the thoracolumbar spine from CT images showing compression fracture.
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During her clinic review at 4 months postpartum, she complained of severe lower back pain which corresponded to T9 to L1 osteoporotic compression fracture (Figure 3).
(A) CT adrenal pre-contrast scan showing the right adrenal adenoma (blue arrow); (B) CT adrenal post-contrast scan showing the well-defined hypodense lesion at the medial limb of the right adrenal gland.
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Adrenal CT scan was only performed at 6 months postpartum which revealed a right medial limb adrenal adenoma measuring 3.1 x 1.9 x 2.9 cm with pre-contrast HU of 31 and 96% absolute contrast washout (Figure 4).