Hyperostosis frontalis ınterna and cranial bone thickness in Cushing syndrome

Introduction

Hyperostosis frontalis interna (HFI) is a cranial bone disorder associated with hormonal and metabolic factors; however, its relationship with Cushing syndrome has not been systematically evaluated. This study aimed to assess the prevalence of HFI and its association with cranial bone thickness in patients with endogenous Cushing syndrome. Material and methods: This retrospective cross-sectional study was conducted to evaluate adult patients with endogenous Cushing syndrome followed at a tertiary endocrinology center between January 2010 and December 2025 who had available cranial magnetic resonance imaging (MRI). Patients were categorized according to the presence or absence of HFI on cranial MRI. Frontal, parietal, and occipital bone thicknesses were measured on T1-weighted axial images. Clinical characteristics and biochemical parameters were compared between groups.