Claudication is best described as which of the following?

• A. Painful leg swelling due to venous obstruction
• B. Pain that worsens at rest and improves with movement
• C. Numbness in the toes at night
• D. A cardinal symptom of peripheral arterial disease where skeletal muscle oxygen demand exceeds blood oxygen supply

Answer: (D)

Claudication arises from peripheral arterial disease causing insufficient blood flow to leg muscles during exercise. When you walk, leg muscles demand more oxygen and nutrients; if the arteries are narrowed or occluded, they can’t increase blood flow adequately, so the muscle becomes ischemic and you feel pain, cramping, or fatigue. This exertional pain, which is relieved by rest as the demand drops, is the classic hallmark of claudication. The description that frames this as a mismatch where skeletal muscle oxygen demand exceeds blood oxygen supply directly captures the mechanism and the clinical hallmark of claudication in PAD. The other options point to conditions that don’t fit this pattern: venous obstruction typically causes leg swelling; pain at rest or with movement isn’t the characteristic exertional claudication pattern; numbness at night suggests neuropathy or rest ischemia rather than the classic exertional pain of claudication.