Bilateral upper neck pain for one week over the area of carotid bulbs, more so on the left side radiating to the left cheek. The pain is relieved when using paracetamol (acetaminophen). Smoker.
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Hypoechoic transmural thickening of the vascular wall at the carotid bulbs bilaterally with localized tenderness. Intact intima. This forms mild luminal narrowing.
Carotidynia is a syndrome characterized by neck pain and focal tenderness at the carotid bulbs area. 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. The pain usually responds to NSAIDs or steroids.