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type: exampleresource: DiagnosticReportexample: diagnosticreport-example-dxa

DiagnosticReport Example: diagnosticreport-example-dxa

Narrative

DXA BONE DENSITOMETRY

NAMEXXXXXXX
DOB10/02/1974
REFERRING DRSmith, Jane
INDICATIONSEarly menopause on estrogen levels. No period for 18 months
PROCEDUREDual energy x-ray absorptiometry (DEXA)

Bone Mineral Density

Scan TypeRegionMeasuredAgeBMDT-ScoreZ-Score?BMD(g/cm2)?BMD(%)
AP SpineL1-L417/06/200834.41.148 g/cm²-0.4-0.5--
Left FemurNeck17/06/200834.40.891 g/cm²-1.0-0.9--
Left FemurTotal17/06/200834.40.887 g/cm²-1.2-1.3--
Right FemurNeck17/06/200834.40.885 g/cm²-1.0-1.0--
Right FemurTotal17/06/200834.40.867 g/cm²-1.4-1.4--

Assessment:

COMMENT

Osteopenia on measured BMD. The estimated 10-year probability of fracture based on present age, gender and measured BMD is less than 10%. This absolute fracture risk remains low. A follow-up assessment may be considered in 2 to 3 years to monitor the trend in BMD.

Thank you for your referral. Dr Henry Seven 17/06/2008

Note: WHO classification of osteoporosis (WHO Technical Report Series 1994: 843)

Example XML

<?xml version="1.0" encoding="UTF-8"?>
<DiagnosticReport xmlns="http://hl7.org/fhir">
    <id value="102"/>
    <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml">
            <h2>DXA BONE DENSITOMETRY</h2>
            <table>
                <tr>
                    <td>NAME</td>
                    <td>XXXXXXX</td>
                </tr>
                <tr>
                    <td>DOB</td>
                    <td>10/02/1974</td>
                </tr>
                <tr>
                    <td>REFERRING DR</td>
                    <td>Smith, Jane</td>
                </tr>
                <tr>
                    <td>INDICATIONS</td>
                    <td>Early menopause on estrogen levels. No period  for 18 months</td>
                </tr>
                <tr>
                    <td>PROCEDURE</td>
                    <td>Dual energy x-ray absorptiometry (DEXA)</td>
                </tr>
            </table>
            <h3>Bone Mineral Density</h3>
            <table>
                <tr>
                    <td>Scan Type</td>
                    <td>Region</td>
                    <td>Measured</td>
                    <td>Age</td>
                    <td>BMD</td>
                    <td>T-Score</td>
                    <td>Z-Score</td>
                    <td>?BMD(g/cm2)</td>
                    <td>?BMD(%)</td>
                </tr>
                <tr>
                    <td>AP Spine</td>
                    <td>L1-L4</td>
                    <td>17/06/2008</td>
                    <td>34.4</td>
                    <td>1.148 g/cm²</td>
                    <td>-0.4</td>
                    <td>-0.5</td>
                    <td>-</td>
                    <td>-</td>
                </tr>
                <tr>
                    <td>Left Femur</td>
                    <td>Neck</td>
                    <td>17/06/2008</td>
                    <td>34.4</td>
                    <td>0.891 g/cm²</td>
                    <td>-1.0</td>
                    <td>-0.9</td>
                    <td>-</td>
                    <td>-</td>
                </tr>
                <tr>
                    <td>Left Femur</td>
                    <td>Total</td>
                    <td>17/06/2008</td>
                    <td>34.4</td>
                    <td>0.887 g/cm²</td>
                    <td>-1.2</td>
                    <td>-1.3</td>
                    <td>-</td>
                    <td>-</td>
                </tr>
                <tr>
                    <td>Right Femur</td>
                    <td>Neck</td>
                    <td>17/06/2008</td>
                    <td>34.4</td>
                    <td>0.885 g/cm²</td>
                    <td>-1.0</td>
                    <td>-1.0</td>
                    <td>-</td>
                    <td>-</td>
                </tr>
                <tr>
                    <td>Right Femur</td>
                    <td>Total</td>
                    <td>17/06/2008</td>
                    <td>34.4</td>
                    <td>0.867 g/cm²</td>
                    <td>-1.4</td>
                    <td>-1.4</td>
                    <td>-</td>
                    <td>-</td>
                </tr>
            </table>
            <p>Assessment:</p>
            <ul>
                <li>The Spine L1-L4 BMD is normal.</li>
                <li>The Left Femur Neck BMD is in the osteopenic range. Relative fracture risk is about 2.</li>
                <li>The Left Femur Total BMD is in the osteopenic range. Relative fracture risk is about 2.</li>
                <li>The Right Femur Neck BMD is in the osteopenic range. Relative fracture risk is about 2.</li>
                <li>The Right Femur Total BMD is in the osteopenic range. Relative fracture risk is about 2.</li>
            </ul>
            <p>
                <b>COMMENT</b>
            </p>
            <p>Osteopenia on measured BMD. The estimated 10-year probability of fracture based on present age, gender and measured BMD is less than 10%. This absolute fracture risk remains low. A follow-up assessment may be considered in 2 to 3 years to monitor the trend in BMD.</p>
            <p>Thank you for your referral.  Dr Henry Seven  17/06/2008</p>
            <pre>
Note:
WHO classification of osteoporosis (WHO Technical Report Series 1994: 843)
- Normal: T-score equal to -1.0 s.d. or higher
- Osteopenia: T-score  between -1.0 and -2.5 s.d.
- Osteoporosis: T-score equal to -2.5 s.d. or lower
- Severe/Established osteoporosis: Osteoporosis with one or more fragility fracture.
T-score: The number of s.d. from the mean BMD for a gender-matched young adult population.
Z-score: The number of s.d. from the mean BMD for an age-, weight- and gender-matched population.
Reference for 10-year probability of fracture risk: Kanis JA, Johnell O, Oden A, Dawson A,  De Laet C, Jonsson B. Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporos.Int. 2001;12(12):989-995.
GE LUNAR PRODIGY DENSITOMETER
</pre>
        </div>
    </text>
    <status value="final"/><!--      femur, laterality = left      --><!--      first, various administrative/context stuff      --><code>
        <coding>
            <system value="http://loinc.org"/>
            <code value="38269-7"/>
        </coding>
        <text value="DXA BONE DENSITOMETRY"/>
    </code>
    <subject>
        <reference value="Patient/pat2"/>
    </subject>
    <effectiveDateTime value="2008-06-17"/><!--      all this report is final      --><issued value="2008-06-18T09:23:00+10:00"/><!--      well, actually. this isn't the patient, but it'll do for now      --><performer>
        <reference value="Practitioner/3ad0687e-f477-468c-afd5-fcc2bf897809"/>
        <display value="Dr Henry Seven"/>
    </performer>
    <result>
        <reference value="Observation/bmd"/><!--	 but just one for now,  but for this example there should be more as listed here 
<reference value="Observation/bmd1"/>      (LEFT  24701-5  DXA Femur [Mass/Area] Bone densityO g/cm2) 
<reference value="Observation/bmd2>      (LEFT 8263-0  Femur DXA [T-score] Bone densityO {T-score})

<reference value="Observation/bmd3"/>      (RIGHT 24701-5  DXA Femur [Mass/Area] Bone densityO g/cm2)
<reference value="Observation/bmd4"/>      (RIGHT 38263-0  Femur DXA [T-score] Bone densityO {T-score})

<reference value="Observation/bmd5"/>      (24966-4  Lumbar spine DXA Bone densityO g/cm2)
<reference value="Observation/bmd6"/>     (38267-1  Lumbar spine DXA [T-score] Bone densityO {T-score})
--></result><!--      the imaging service marks this to help find categories of patient      --><conclusionCode>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="391040000"/>
            <display value="At risk of osteoporotic fracture"/>
        </coding>
    </conclusionCode>
</DiagnosticReport>