CUSHING'S VS. PCO

There is no assertion of any diagnostic procedure to confirm any of these two cases.
PCO is diagnosed upon clinical criteria, diagnosis can be supported later by US, while LH\FSH ratio is not always needed, it is not sensitive and maybe not specific too.
Cushing SYNDROME diagnosis can be established by gathering 24 hours urine for cortisol, low dose DST and high dose DST is THEN used to differentiate between cushing disease and cushing syndrome, this is the new strategy for diagnosis of cushing. (don’t begin with DST)

That's why this case may confuse us PLUS Cushing's cured by surgery and PCO needs only symptomatic treatment.

- Does high 24 hour urine cortisol confirm cushing's and deny PCO?

from emedicine:
Cushing syndrome can be ruled out by checking a 24-hour urine sample for free cortisol and creatinine. Levels of urinary free cortisol that are 4-fold the upper limit of normal are diagnostic for Cushing syndrome.

so i think it is good test to role out pco....

They didn't say that, they said that normal 24 hour urine cortisol can role out CUSHING'S!

sorry.... just a mistake.....
i mean Cushing's