For our 65th episode, we return to The Journal of Clinical Endocrinology & Metabolism to look at a report of two different studies that investigate the relationship between MACS (mild autonomous cortisol secretion) and vertebral fractures. MACS has been of increasing interest to endocrinologists over the past few years, with a greater recognition of its health impact and new guidelines on its assessment and treatment. As this topic continues to evolve, we thought that this paper has a high likelihood of impacting our clinical care and so is well worth discussion. Host Chase Hendrickson, MD, from Vanderbilt University talks with regular contributor Jill Wagoner, MD, from the University of Nebraska Medical Center, and guest expert Oksana Hamidi, DO, from the University of Texas Southwestern Medical Center. They discuss “Adrenalectomy Reduces the Risk of Vertebral Fractures in Patients With Mild Autonomous Cortisol Secretion” by Morelli et al, first published online in JCEM in April 2025.