Carotidynia Versus Transient Perivascular Inflammation of the Carotid Artery (TIPIC) Syndrome: Finding Common Ground

Abstract

Carotidynia remains mired in controversy. Whether to identify this self-limiting unilateral neck pain as a distinct clinical entity or a diagnostic sign associated with a variety of conditions remains a topic of ongoing debate. Adding to the discussion is the occasional finding on imaging studies of a transient inflammatory process surrounding the carotid artery in a number of individuals who present with unilateral neck pain. Although some use carotidynia as the designation of choice by which to identify this inflammatory process, the acronym TIPIC (transient perivascular inflammation of the carotid artery) syndrome is being touted as a far more descriptive and less contentious alternative. Having TIPIC syndrome replace carotidynia, however, need not necessarily signal the latter's outright elimination as some have advocated. When used as a diagnostic sign, carotidynia provides an appreciation of the many conditions that may be associated with idiopathic unilateral neck pain.

Transient perivascular inflammation of the carotid artery: Ultrasonography and magnetic resonance imaging findings

“…Contrast‐enhanced MR imaging may show contrast enhancement in vessel wall and perivascular soft tissue. Transient fatty plaques may be visualized in carotid arteries in the recovery phase 2,4,6 …”

“…Transient fatty plaques may be visualized in carotid arteries in the recovery phase. 2,4,6 Carotid artery dissection should be primarily considered in the differential diagnosis of TIPIC syndrome. In addition, other inflammatory arteriopathies, such as giant cell arteritis, Takayasu arteritis, postradiation carotid arteritis, fibromuscular dysplasia, carotid trunk paragangliomas, sialadenitis, thyroiditis, peritonsillar abscess/phlegmon, cervical spondylosis, and neck neoplasms should also be remembered in its differential diagnosis.…”

“…In addition, other inflammatory arteriopathies, such as giant cell arteritis, Takayasu arteritis, postradiation carotid arteritis, fibromuscular dysplasia, carotid trunk paragangliomas, sialadenitis, thyroiditis, peritonsillar abscess/phlegmon, cervical spondylosis, and neck neoplasms should also be remembered in its differential diagnosis. 2,4,[6][7][8][9] No treatment guideline currently exists for the treatment of TIPIC syndrome. Non-steroidal anti-inflammatory drugs are usually used to hasten its recovery.…”

“…Antibiotics are very rarely used to treat patients with TIPIC. 2,[4][5][6]9 4 | CONCLUSION TIPIC syndrome is a rare clinical entity that should be definitely considered in patients presenting with unilateral neck pain. It should be noted that patients with TIPIC syndrome may present with diverse clinical manifestations.…”

Transient perivascular inflammation of the carotid artery—A transient but potentially recurrent disease

“…Transient perivascular inflammation of the carotid artery (TIPIC syndrome) is a rare, unclassified vascular syndrome with a prevalence of 2.8% in patients with acute neck pain 1,2 . The disease usually affects the distal part of the common carotid artery and was thought to have a monophasic course with a favorable prognosis after treatment with anti‐inflammatory drugs 2,3 …”