Abstract
Carotidynia is a syndrome characterized by tenderness of the carotid artery near the bifurcation due to numerous, heterogeneous causes. Here we reported the case of a 31-year-old Moroccan woman with right-sided neck pain and tenderness with irradiation to ipsilateral ear, eye, and occipital region. Clinical symptoms and imaging findings were suggestive of primary variant of carotidynia syndrome. In particular, color-Doppler ultrasonography revealed a concentric wall thickening of the distal common carotid artery, while thoracic magnetic resonance showed localized perivascular enhancement of the soft tissue in the right medial-distal common carotid artery in T1-weighted images, without intraluminal diameter variation. Moreover, careful clinicoserological and imaging investigations (cranial, cervical, and thoracic angiocomputed tomography and magnetic resonance) excluded well-known disorders potentially responsible for carotidynia syndrome. The patient was scarcely responsive to nonsteroidal anti-inflammatory drugs, but clinical symptoms resolved after three months. Of interest, the patient showed latent Mycobacterium tuberculosis infection (positive tuberculosis interferon-gamma release assay; QuantiFERON-TB Gold); this finding suggested a possible triggering role of mycobacterial antigens in the immune-mediated mechanism responsible for localized carotid injury.
Highlights
Carotidynia is a syndrome characterized by either unilateral or bilateral tenderness of the carotid artery near the bifurcation, first described in 1927 by Fay [1]
The clinical and imaging features observed in the patient here described were quite typical of carotidynia syndrome
Careful clinicoserological and radiological investigations excluded well-known disorders potentially responsible for this syndrome; the present case can be classified as primary variant of carotidynia
Summary
Carotidynia is a syndrome characterized by either unilateral or bilateral tenderness of the carotid artery near the bifurcation, first described in 1927 by Fay [1]. It has been considered as merely symptom of numerous, heterogeneous causes of neck pain (infections, migraine, trigeminal neuralgia, neoplasms, eagle syndrome, and various carotid disorders including aneurysm, dissection, occlusion, or inflammation, i.e., carotid arteritis), and less frequently as a distinct clinicopathological entity [2,3,4]. We describe a patient with these peculiar clinicoradiological findings suggestive of primary variant of carotidynia syndrome
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