A Case of Carotidynia in Which Imaging Findings Helped Diagnosis

Abstract

Carotidynia is a relatively rare disorder characterized by unilateral neck pain or swelling, without physical dysfunction. Although it is thought to arise from nonspecific inflammation of the carotid artery tissue, the precise cause remains unknown.

The patient was a 40-year-old man who presented with electric shock-like pain coursing along the left carotid artery when he applied pressure on the neck, became angry, or was swallowing. Physical examination showed no evidence of organic dysfunction and hematological examination revealed no abnormalities. On the other hand, cervical ultrasonography revealed a low-echoic lesion and local thickening of the wall of the left common carotid artery. Contrast-enhanced T2-MRI revealed a high-intensity lesion and local thickening of the soft tissues surrounding the left common carotid artery. Based on the findings, we administrated only anti-inflammatory agents, considering that there was no evidence of infection. The pain resolved completely after 7 days of treatment and has not recurred. At this time, the patient was definitively diagnosed as having suffered from carotidynia, because the symptom rapidly disappeared with only anti-inflammatory drugs, and no evidence of organic disorder was found.

It is important for otolaryngologists to bear in mind the possibility of carotidynia in the differential diagnosis of acute neck pain. Ultrasonography and MRI examinations are most useful for a precise diagnosis.