In a patient with CEAP classification 2, what is the most suitable test to investigate cramping in the lower extremities after walking?

In the context of investigating cramping in the lower extremities after walking, particularly in a patient classified as CEAP 2, which indicates the presence of varicose veins without skin changes, Ankle-Brachial Index (ABI) testing is the most appropriate choice. ABI testing measures blood flow and can help determine if there is peripheral artery disease (PAD), which is a common cause of cramping in the legs during exercise due to insufficient blood flow. This evaluation is particularly suitable for patients who report claudication symptoms, which is often characterized by pain or cramping in the legs during physical activity.

The significance of ABI testing lies in its simplicity, non-invasiveness, and ability to provide a quick assessment of vascular health. It compares the blood pressure in the patient's ankle with that in the arm, helping to identify any discrepancies that indicate arterial blockages.

In contrast, venography is an invasive procedure primarily used to visualize veins directly and may not be necessary for diagnosing cramping related to arterial issues. Doppler ultrasound is also a valuable tool for assessing blood flow and venous pathologies, but it is less specific than ABI in identifying arterial insufficiency. CT angiography, while useful for detailed imaging of blood vessels, involves radiation exposure