If you've been dealing with leg pain, numbness, or a slow-healing wound and your orthopedic doctor mentioned "ABI," you might have a lot of questions. That is completely understandable. The Ankle-Brachial Index is one of the simplest and most informative tests we can perform, yet it often comes as a surprise to patients who expected a knee or hip issue.
At M&S Vascular and Orthopedic Group P.C. in Forest Hills, Queens, NY, we treat the full picture of lower-extremity problems. That means our vascular specialists and orthopedic surgeons work side by side, so you do not have to bounce between two separate practices to get complete answers. Whether your leg pain is mechanical, vascular, or a mix of both, you get one coordinated plan.
What Is the Ankle-Brachial Index (ABI) Test?
The ABI is a quick, non-invasive measurement of blood flow in your legs. A small blood pressure cuff is placed on your ankle and your upper arm. A Doppler ultrasound device picks up the pulse signals, and a ratio is calculated.
A normal ABI falls between 0.9 and 1.3. A reading below 0.9 suggests some degree of peripheral artery disease (PAD), where narrowed or blocked arteries reduce blood flow to your legs. A reading above 1.3 can indicate stiff, calcified vessels, which is common in long-standing diabetes.
The entire test takes about 10 to 15 minutes. There is no injection, no radiation, and no recovery time. You can walk out and go back to your day.
Why ABI Testing Matters for Orthopedic Patients
Here is the part many patients do not expect: leg pain is not always a bone or joint problem.
When someone limps or reports "claudication" (cramping in the calf after walking a certain distance), the first instinct is to suspect a spinal issue, a hip problem, or a tendon injury. But reduced arterial blood flow can mimic all of those conditions. If you treat the joint while the blood supply is compromised, healing will be slow or incomplete.
Dr. Mehran Manouel, our orthopedic surgeon and sports medicine specialist, routinely orders or reviews ABI results before planning any lower-extremity procedure. If your circulation is poor, that changes the surgical approach, the anesthesia choice, and the recovery timeline. Getting the ABI first prevents surprises and protects your outcome.
Dr. Amir Salem, our interventional radiologist and vascular surgeon, steps in when the ABI points to a blockage that needs addressing. He can perform minimally invasive catheter-based procedures to open narrowed arteries, often in the same visit or within days.
Symptoms That Should Prompt You to Ask About an ABI
You do not need a diagnosis to request this test. If any of the following have been going on for more than a couple of weeks, it is worth a conversation with your doctor:
- Calf, thigh, or buttock cramping after walking a predictable distance that eases with rest
- Cold feet or toes that feel noticeably cooler than the rest of your body
- Shiny, thin skin on the lower leg or loss of hair below the knee
- A wound on your foot or ankle that is not healing after two or three weeks
- Numbness or tingling in the toes that is not explained by a single nerve
- A change in foot color (pale when raised, reddish-purple when lowered)
If you have diabetes, a history of smoking, high cholesterol, or a family history of heart disease, the threshold for getting an ABI should be even lower. These factors accelerate arterial narrowing, and catching it early makes a real difference.
What to Expect at Your M&S Vascular Visit
Your first appointment in our Forest Hills office is thorough but straightforward. Here is a typical flow:
The intake. You will fill out a medical history form and discuss your symptoms, medications, and any prior imaging. Be honest about smoking, diabetes, and any previous leg or foot problems. This context shapes everything that follows.
The physical exam. The doctor will check your pulses, inspect your skin, assess your gait, and perform basic joint and nerve checks. This takes five to ten minutes.
The ABI measurement. A technician or the doctor will place cuffs on both arms and both ankles. You will hear a soft "whoosh" from the Doppler as they record the pressures. You will see the numbers on a screen. The doctor will explain what they mean in plain language.
The discussion. If the ABI is normal, the conversation shifts to the orthopedic or soft-tissue cause of your symptoms. If it is abnormal, Dr. Salem will walk you through the next steps, which may include a duplex ultrasound, a CT angiogram, or a direct catheter-based intervention.
You will leave the visit with a clear plan, a printed copy of your ABI numbers, and a follow-up date. No one sends you home wondering what happened.
How Our Vascular and Orthopedic Teams Work Together
This is the part that sets M&S Vascular apart from a single-specialty clinic.
Imagine a 62-year-old patient with chronic calf pain and a mild knee osteoarthritis. In a typical setup, the orthopedic surgeon sees the knee, the vascular surgeon sees the artery, and the patient is left to connect the dots. Here, both doctors review the same chart, the same imaging, and the same ABI result.
Dr. Manouel can plan a joint procedure knowing the arterial supply is adequate, or flag a case where vascular optimization should come first. Dr. Salem can perform a stent or angioplasty and then clear the patient for the orthopedic workup without a months-long wait between specialists.
For sports medicine patients in Queens who play recreational basketball or run, this combined approach means we can clear you for return to activity with confidence that both the structural and circulatory sides are addressed.
Treatment Options and Recovery
The right treatment depends entirely on what the ABI and any follow-up imaging show.
Lifestyle and medication. Mild PAD (ABI between 0.7 and 0.9) is often managed with a supervised walking program, statins, antiplatelet therapy, smoking cessation, and blood sugar control. Many patients see meaningful improvement in their symptoms within six to eight weeks of consistent walking.
Catheter-based intervention. For more significant blockages, Dr. Salem performs percutaneous procedures: balloon angioplasty, stent placement, or atherectomy to remove plaque. These are done under local anesthesia with a small groin or wrist puncture. Most patients go home the same day or the next morning.
Surgical bypass. In rare cases where the blockage is long or multiple, a surgical bypass may be recommended. This is a larger procedure with a hospital stay, but it is reserved for situations where less invasive options are not appropriate.
Orthopedic treatment. Once circulation is optimized, Dr. Manouel addresses the joint, tendon, or ligament issue. Recovery protocols are tailored to your vascular status, with close monitoring of the incision site and wound healing.
No doctor can promise a specific outcome, and every plan is adjusted to your unique anatomy and health history. What we can promise is that you will understand each step before we take it.
Frequently Asked Questions
How often should I repeat an ABI?
If your ABI is normal and you have no risk factors, every five years is reasonable. If you have diabetes, PAD, or a prior intervention, your doctor will likely recommend annual or biannual checks.
Does the ABI test hurt?
No. The cuffs are the same ones used for a standard blood pressure reading. You may feel mild tightness for a few seconds, but there is no pain.
Can I walk or exercise after the test?
Yes. There is no restriction. You can resume your normal activities immediately.
Do I need a referral to see M&S Vascular?
We accept most major insurance plans and self-pay patients. A referral is helpful but not always required. Call our office and we will confirm your specific coverage.
Can Dr. Manouel and Dr. Salem see me on the same day?
In many cases, yes. Our scheduling team coordinates both visits to minimize your trips to the office.
Ready to Get Clear Answers About Your Legs?
If you have been putting off that leg pain, or if a previous doctor mentioned an ABI and you are not sure what to do next, you do not have to figure it out alone. Our team in Forest Hills, Queens, NY is here to walk through every number, every image, and every option with you.
Call (718) 897-2228 to schedule a visit, or explore our services at www.msorthovasc.com. We will get you the full picture, not just half the story.