Carotidynia is a syndrome characterized by unilateral neck pain and focal tenderness, usually at, but not always to, the limited to the site of carotid bifurcation. The etiology of this syndrome is unknown.

Diagnosis can be made clinically, and should be established after ruling out other more serious causes of carotid wall thickening, including large vessel vasculitides.

MRI findings typically include ill-defined soft tissue thickening within the carotid sheath, usually at the carotid bifurcation. The soft tissue displays hyperintense signal on T2 and T2FS sequences. On T1FS sequences, it appears iso-intense, as opposed to the hyperintensity of intramural hematoma of dissection. On post gadolinium T1 FS sequence, the thickened soft tissue shows moderate to intense enhancement, again a point which is helpful in differentiating this entity from dissection. The lesion does not cause any significant narrowing of the carotid lumen.

The pain usually responds to NSAIDS or steroids.