A 71-year-old woman with no medical history of note presented to the Department of Internal Medicine of the Vall d’Hebron University Hospital in August, 2013, with 1 month of joint pain. She also had cutaneous oedema with subcutaneous hardening that started in her legs, then spread to the trunk and arms, affecting the distal region of the limbs. On examination she had mild erythema and mild pitting leg oedema, and hardening of the subcutaneous tissue of the limb, lumbar, and breast areas. Both forearms showed a linear depression in the skin parallel to the course of the superficial veins, more obvious on raising the arm, that was consistent with the groove sign (figure).
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The vascular groove sign is a moderately sensitive but highly specific sign for distinguishing osteoid osteomas from other radiolucent bone tumors on CT.
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