• initial appointment with a professor of dermatology and allergology, medical history taking;
• diagnosis of seasonal rhinitis (allergy to tree and grass pollen);
• diagnosis of perennial rhinitis/rhinoconjunctivitis (allergy to house dust, animal dander, etc.);
• comprehensive blood testing (IgE) for a wide range of food, inhalant and household allergens;
• blood test for food intolerance (IgG);
• skin prick testing with various food, inhalant and household allergens;
• patch testing with the most common contact allergens (metals and chemicals);
• diagnosis of all types of urticaria;
• the latest autologous serum skin test (to identify an autoimmune, «internal» cause of urticaria);
• diagnosis of latent bronchospasm;
• cytological and bacteriological examination of mucosal secretions;
• virological testing;
• immunological testing.

German allergology clinics carry out a comprehensive work-up of children of any age to detect allergic reactions to external triggers.

Alongside standard skin scratch tests, clinics also use the most advanced method available – the allergy panel. This is a laboratory test that uses a set of specific antigens (pollen, food components, animal dander, etc.) to detect immunoglobulins of the IgG and IgE classes in the patient's blood serum, which indicates that allergic reactions to the antigens of a particular trigger are developing or already present.

The advantage of the allergy panel over skin tests is that the allergen has no direct effect on the body.

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• initial appointment with a professor of gastroenterology, medical history taking;
• physical examination;
• body mass index (BMI) measurement;
• blood pressure and pulse measurement;
• comprehensive laboratory tests, including urinalysis;
• ultrasound of the abdominal and pelvic organs (liver, stomach, gallbladder and bile ducts, spleen, pancreas);
• ultrasound of the kidneys, adrenal glands and bladder;
• video oesophagogastroduodenoscopy (with biopsy of the gastric mucosa);
• colonoscopy (with polyp removal) under sedation, on an empty stomach;
• test for the gastric bacterium Helicobacter pylori;
• final consultation and discussion of the examination results with the specialist;
• prescription of treatment and preventive measures;
• a written report in German on the diagnostic findings, with treatment and prevention recommendations.

*The biopsy cost for removed polyps depends on how many are removed.

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Genetic testing involves the following stages:

• genetic counselling with medical geneticists;
• medical examination and consultations with relevant specialists;
• taking a family history;
• determining the mode of inheritance and the recurrence risk for the patient and their blood relatives;
• discussion of the genetic test results;
• multidisciplinary treatment recommendations for monitoring and managing the condition;
• collection or review of genetic material, such as:

• blood, including heparinised blood;
• saliva;
• amniotic fluid;
• chorionic villi;
• heparinised cord blood;
• tumour tissue (for microsatellite analysis);
• other tissues.

Molecular genetics centres carry out the following analyses:

• molecular genetic testing to establish biological relatedness;
• DNA diagnostics of hereditary diseases, including a number of cancers;
• DNA diagnostics of infertility;
• HLA typing.

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• initial appointment with a gynaecologist and breast specialist, medical history taking;
• physical examination (palpation of the breasts and regional lymph nodes);
• breast ultrasound;
• gynaecological examination — early detection of cancer of the ovaries, fallopian tubes, cervix, uterus and labia;
• pelvic ultrasound;
• transvaginal ultrasound;
• fertility assessment (evaluation of reproductive function);
• Papanicolaou smear (PAP test) from the cervical canal (cervix) for cytological analysis;
• for women of menopausal age — selection of drug therapy;
• counselling on contraception to prevent unwanted pregnancy;
• final consultation and discussion of the examination results with the specialist;
• prescription of therapeutic and preventive measures;
• a written report in German on the diagnostic findings, with recommendations for treatment and prevention.

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• 12-lead resting ECG;
• exercise ECG: bicycle ergometry and treadmill test;
• Holter ECG monitoring (24 to 72 hours);
• remote electrographic monitoring of myocardial function using a cardiac event recorder;
• 2D and 3D ultrasound of the heart (echocardiography);
• laboratory tests;
• pulmonary function testing;
• stress echocardiography (stress echo);
• 24-hour ambulatory blood pressure monitoring (ABPM);
• ergospirometry;
• tilt table test;
• three-mode echocardiography unit: M-mode (one-dimensional echocardiography), B-mode (two-dimensional echocardiography) and Doppler mode (Doppler echocardiography);
• non-invasive cardiac imaging (multislice magnetic resonance
  imaging, computed tomography, echocardiography, stress echocardiography and transoesophageal echocardiography);
• electrophysiology study (EPS);
• capillary microscopy;
• coronary angiography, aortography and selective left ventriculography;
• left heart catheterisation for diagnostic examinations;
• right heart catheterisation;
• intravascular ultrasound imaging;
• measurement of blood flow velocity in the coronary vessels;
• rotational atherectomy (rotablation);
• echocardiography, stress echocardiography, three-dimensional echocardiography, transoesophageal echocardiography;
• myocardial scintigraphy;
• PET (positron emission tomography) and single-photon emission computed tomography (SPECT);
• sonography (ultrasound) of the thyroid gland, duplex sonography of the arteries supplying
• the brain and of the peripheral arteries;
• transthoracic Doppler echocardiography;
• digital angiography of the arteries;
• aortography;
• arteriography of the iliac, femoral and popliteal arteries;
• digital subtraction angiography (DSA);
• intravascular ultrasound (IVUS) of the coronary arteries;
• tissue Doppler echocardiography;
• whole-body plethysmography.

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• CT at the department of radiology/neuroradiology;
• MRI at the department of radiology/neuroradiology;
• ultrasound of the major arteries and the arteries of the brain parenchyma;
• neuropsychology;
• clinical neurophysiology (electromyography/EMG, evoked potentials, EEG,
• transcranial magnetic stimulation);
• neuropsychological assessment;
• electroneuromyography (ENMG);
• evoked potentials;
• posturography;
• oculography in the laboratory of perception and oculomotor control (motor function of the oculomotor nerves);
• neurosonography;
• telemetric electroencephalography;
• polysomnography;
• nerve biopsy;
• cerebrospinal fluid analysis;
• cognitive diagnostics;
• neuropsychological testing;
• muscle biopsy;
• motor function laboratory;
• neuromorphology laboratory.

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• palpation;
• hormone panel testing;
• thyroid ultrasound scan;
• blood tests for hormones,
• CT scan of the thyroid gland;
• MRI scan of the thyroid gland.

Confirmatory diagnostics:

• thyroid scintigraphy with Tc-99m pertechnetate;
• parathyroid scintigraphy with Tc-99m-MIBI or SPECT;
• fine-needle aspiration biopsy.

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• continuous-wave Doppler measurement of peripheral arterial occlusion pressures, including toe occlusion pressures;
• acral photoplethysmography, segmental oscillography, functional oscillography;
• treadmill ergometry;
• capillary microscopy, microcirculation assessment (laser Doppler flowmetry);
• duplex sonography of all arterial territories – transcranial Doppler ultrasound;
• duplex sonography and compression sonography of all venous territories;
• venous occlusion plethysmography (VVP);
• intra-arterial angiography of all arterial territories, phlebography of all venous territories;
• MR and CT angiography of all arterial and venous territories;
• laboratory testing for atherosclerotic and thrombophilic risk factors.

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• optical coherence tomography (OCT);
• digital fluorescein angiography;
• photodocumentation of the anterior and posterior segments of the eye;
• ultrasound A-scan (echobiometry);
• corneal topography using the Placido and Scheimpflug methods;
• wavefront analysis;
• endothelial microscopy;
• corneal pachymetry;
• optical biometry with the IOL Master (Zeiss IOL-Master);
• keratometry;
• HRT – tomography;
• automated perimetry;
• Goldmann perimetry;
• refractometry;
• applanation and non-contact tonometry;
• electrophysiology (EOG, ERG).

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• a full clinical examination (assessment of physical and psychomotor development);
• anthropometry (weight, height, head circumference, chest circumference);
• examination of the skin and scalp;
• examination of the visible mucous membranes: the conjunctiva of the eyes, the oral cavity and the throat;
• examination and palpation of the thyroid area;
• palpation of the peripheral lymph nodes: submandibular, inguinal and axillary;
• assessment of the circulatory system (inspection, percussion and auscultation of the heart);
• assessment of the respiratory system (percussion and auscultation of the lungs);
• assessment of the digestive system (palpation of the abdominal organs, the right hypochondrium, the liver, the epigastric region, the spleen, the right and left iliac regions and the suprapubic region);
• abdominal ultrasound;
• external examination of the genitals;
• examination of the breasts in girls;
• a clinical blood test, a clinical urine test and a stool test for helminth infestation;
• counselling for parents on the child's health and development;
• recommendations on care, nutrition, vaccination and ongoing follow-up.

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• clinical examination;
• forced computerised spirography — assessment of pulmonary function, including bronchodilator testing (provocation tests with a muscarinic agonist);
• ultrasound of the pleural cavity;
• X-ray of the lungs and pleural cavity in different projections (if indicated);
• routine clinical tests of blood, urine and secretions;
• electrocardiography (ECG);
• Doppler echocardiography (echo) with blood flow assessment (if indicated);
• body plethysmography — measurement of total lung capacity and its subdivisions, airway resistance and lung compliance;
• arterial blood gas analysis (oximetry) — assessment of the diffusing capacity of the lungs and alveolar volume;
• 24-hour Holter ECG monitoring (if indicated);
• bronchoscopy under local anaesthesia (if indicated);
• testing for common inhalant allergens (pollen, house dust mite, moulds) — if indicated.

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Early detection of skin cancer relies on regular preventive check-ups of the entire body surface, including the mucous membranes of the eyes and mouth, the scalp and the genital area, carried out with a dermatoscope. Dermatoscopes are indispensable for examining skin lesions (pigmented spots, naevi, melanomas) in order to detect malignant disease early and treat it in good time. These digital handheld devices transilluminate the skin surface layer by layer.
Dermatoscopes are fitted with a set of achromatic lenses and an LED illumination system for the area under examination, and they deliver a high degree of resolution.
They make it possible to carry out a differential diagnosis of pigmented spots, to detect melanoma at an early stage, to assess the distribution of pigmented spots and to distinguish non-melanocytic lesions from malignant ones.
Screening for the early detection of skin cancer in Germany uses the ABCD rule, which allows lesions to be classified as suspicious:

A asymmetry: the lesion has an irregular shape;
B border: the edge is blurred and faded;
C colour: it shows several different shades of colour;
D diameter: the diameter has grown by more than 2 mm within a year.

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• examination and palpation of the external genitalia;
• palpation of the prostate;
• transrectal ultrasound (TRUS — transrectal ultrasound examination of the prostate);
• measurement of prostate-specific antigen (PSA) and
  testosterone levels (from the age of 40);
• if indicated: fusion biopsy of the prostate (transrectal and transperineal);
• if indicated: MRI-guided biopsy of the prostate.

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• physical examination (inspection and palpation of the breasts and lymph nodes);
• breast ultrasound;
• mammography (after the age of 35);
• breast MRI (if indicated);
• needle biopsy (if indicated).

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• examination by a gynaecologist, including manual assessment of the uterine body;
• ultrasound scan of the pelvic organs;
• Papanicolaou test (cervical smear for cancer cytology);
• where indicated, testing for human papillomavirus (HPV).

to clarify the diagnosis:

• CT scan of the uterus and adnexa;
• needle biopsy of the uterus.

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• a comprehensive examination of the teeth, oral mucosa, gums and jaws;
• a tooth vitality test — assessment of the condition of the dental pulp using special medical sprays or cold stimuli, and of the extent and depth of tooth damage;
• digital panoramic radiography of the upper and lower jaw (a high-quality overview image of the teeth and the adjacent soft and hard tissues with minimal radiation exposure);
• diagnostic assessment of the temporomandibular joint and the maxillary sinuses;
• review and analysis of the images of the upper and lower jaw.

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• examination and palpation of the external genitalia;
• ultrasound of the scrotum, vas deferens, seminal vesicles and external genitalia;
• palpation of the prostate, testicles, epididymides, scrotum, penis and spermatic cords;
• examination of the skin of the pubic area| ultrasound of the pelvic vessels and organs;
• ultrasound of the kidneys, adrenal glands and bladder| transrectal ultrasound (TRUS — transrectal ultrasound examination of the prostate);
• laboratory diagnostics (extensive laboratory work-up: blood tests for tumour markers, PSA, sexually transmitted infections and male sex hormones, urine test for bacterial flora);
• diagnosis of erectile dysfunction (if symptoms are present);
• cystoscopy with targeted biopsy (to diagnose bladder tumours);
• percutaneous kidney biopsy (to diagnose tumours and systemic diseases);
• intravenous excretory urography (to assess the structure and excretory function of the kidneys);
• voiding cystourethrography (assessment of the structure and function of the bladder and urethra);
• retrograde urethrography (assessment of the function and structure of the urethra);
• retrograde pyelography (assessment of the structure of the renal pelvis in urolithiasis and pyelonephritis);
• contrast-enhanced computed tomography (to diagnose tumours of the kidneys and urinary tract and to search for metastases);
• magnetic resonance imaging;
• kidney scintigraphy (to assess the excretory function of the kidneys);
• positron emission tomography (to search for metastases, for example in prostate cancer, prostate adenoma, testicular cancer or renal carcinoma);
• functional studies (uroflowmetry, cystometry, video urodynamics).

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