Introduction: Adrenal incidentalomas are a rare but vexing problem for the endocrinologist. There are no Indian data on the subject. The study objective was to look at the characteristics of a group of patients with adrenal incidentaloma from Eastern India. Material And Methods: Retrospective study in a private endocrinology clinic handling refered case in 23 patients seen between 1996 and 2003. Measurements: Clinical and radiological outcome measures. Results: 12 patients were followed up and 11 patients were advised surgery. Of the 8 patients who eventually had surgery, 5 had adrenal adenoma, 2 had adrenal carcinoma and 1 had fat necrosis following pancreatitis. Persistent pain was taken as an indication for surgery. Of the patients advised follow up, 2 were diagnosed adrenal histoplasmosis and one as probable tuberculosis. Conclusions FANC was a good tool in hypodense lesions of probable infective aetiology. Leison size was important in decision making but other imaging information was not. Poorly localized pain was an indication for surgery and gave good results.

The rigorously investigated drugs reported to reduce vertebral fractures are alendronate, risedronate, raloxifena and PTH HRT is no longer first choice for fracture prevention given the risk for adverse events, even though these risks are small. Evidence supporting the use of calcitonin, fluoride, anabolic steroids, active vitamin D metabolites is inadequate. The rigorously investigated drugs reported to reduce non-vertebral fractures are the two bisphosphonates and PTH. Evidence for anti-hip fracture efficacy is confined to the two bisphosphonates. Calcium and vitamin D and hip protectors have been reported to reduce hip fractures in institutionalized elderly. Women and men with fragility fractures should be treated with agents that have been thoroughly investigated.