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However, if conservative management does not relieve your symptoms, or if your knee becomes unstable, further evaluation may be necessary

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doi: 10.1016/j.ejphar.2020.173581 79 ZhangHLiuYChengLMaXLuoX

When cortisol-related symptoms persist despite lifestyle modificationincluding progressive central weight gain, easy bruising, proximal muscle weakness, wide purple striae, resistant hypertension, unexplained osteoporosis, or hypokalemiaformal endocrine evaluation is warranted to exclude pathological hypercortisolism requiring specialized intervention