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IHS Diagnosis ICD-10
11.2.2 Headache attributed to retropharyngeal tendonitis [M79.8] G44.842  

Diagnostic criteria:

  1. Unilateral or bilateral non-pulsating pain in the back of the neck, radiating to the back of the head or to the whole head and fulfilling criteria C and D
  2. Swollen prevertebral soft tissues, in adults measuring >7 mm at the level between C1 and C4 (special x-ray technique may be required)
  3. Pain is aggravated severely by bending the head backwards
  4. Pain is alleviated within 2 weeks of treatment with non-steroidal anti-inflammatory drugs in their recommended doses

Comments:

Body temperature and erythrocyte sedimentation rate (ESR) are usually elevated. Although retroflexion of the neck most consistently aggravates pain, this also usually happens with rotation and swallowing. The transverse processes of the upper three vertebrae are usually tender to palpation.

In several cases amorphous calcific material has been aspirated from the swollen prevertebral tissues. Thin calcification in prevertebral tissues is best seen on CT.

Upper carotid dissection should be ruled out.

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