Carotidynia

Case contributed by Dr Zach Drew

Presentation

1 week history of right sided neck pain, tender to palpation. No significant past medical history. No systemic symptoms.

Patient Data

Age: 30 years old
Gender: Male
CT

CT neck angiogram

Mild-moderate circumferential wall thickening of the right common carotid artery asymmetric compared to the left common carotid artery.  No significant luminal narrowing,

MRI

MRI

MRI confirmed CT findings, showed enhancing wall thickening of the right common carotid artery extending from adjacent to the superior pole of right thyroid lobe to the common carotid artery bifurcation. 

Case Discussion

This patient was investigated by vascular, rheumatology and ENT specialist teams. Differential diagnosis included vasculitis, however, based on normal blood inflammatory markers and lack of any systemic symptoms, most likely diagnosis was thought to be carotidynia. Symptoms resolved with anti inflammatory medication and analgesia.

Carotidynia (also known as Fay syndrome and transient perivascular inflammation of the carotid artery syndrome (TIPIC syndrome)) is a rare condition presenting with unilateral neck pain - usually with focal tenderness on palpation - often around the level of the carotid bifurcation 1. Imaging usually shows circumferential thickening of the distal common carotid, carotid bifurcation or proximal internal carotid artery wall. It is usually a diagnosis of exclusion and tends to be self-limiting.

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Case information

rID: 72393
Published: 23rd Nov 2019
Last edited: 23rd Nov 2019
Inclusion in quiz mode: Included

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