An x-ray of the chest (chest x-ray) is part of the standard program in pulmonology and provides an initial overview. If possible, the image is taken while the patient is standing and in two planes (from back to front = posterior-anterior and lateral), usually after maximal inspiration.
Computed tomography (CT) is very well suited for imaging the lungs; although it is associated with higher radiation exposure, it offers better resolution. In the case of special questions, contrast media can also be injected into the airways or vessels with both procedures.
Magnetic resonance imaging (MRI) can be used to visualize the soft tissues around the lungs and large vessels in the chest cavity; if it is combined with inhalation of the inert gas helium, statements can be made about lung function, as with scintigraphy.
Ultrasound examination (sonography) is primarily used to detect and puncture fluid accumulations in the pleural sac (pleural effusion).
Nuclear medicine examinations using radioactively labeled substances include pulmonary scintigraphy, which is used to detect or rule out pulmonary embolism, and positron emission tomography (PET), which is used to examine suspicious round foci.
Endoscopic procedures
- Bronchoscopy: this is mainly used to clarify suspected tumors, injuries, foreign bodies, infections, diseases of the lung support tissue, unclear complaints such as cough, shortness of breath and bloody sputum, and unclear X-ray findings. In addition, minor procedures such as suctioning mucus, sclerosing bleeding or inserting a prosthesis can be performed. The flexible tube is thereby introduced through the mouth or nose.
- Thoracoscopy: this allows the pleural cavity and the lung surface to be examined, for example, in cases of suspected pleural tumors, diseases of the lung support tissue or repeated pleural effusions, biopsies can be taken and minor operations can be performed. The rigid tube is thereby inserted under anesthesia through a small skin incision between two ribs.
- Mediastinoscopy: This is used mainly for the diagnosis of lymph node enlargement in the area of the mediastinum. The rigid tube is inserted under anesthesia through a small incision in the neck.
Allergy testing
If symptoms and examinations indicate allergy as the cause of respiratory symptoms, appropriate tests are performed to find the triggers. These include skin tests in which various substances are placed in the skin, avoidance tests (i.e., avoiding the suspected allergen), laboratory tests that determine various antibodies, and provocation tests in which the suspected triggers are inhaled. It is recommended that these allergy diagnostics, as well as the other special lung tests, be performed by an appropriate specialist.
