Diagnosticreport-example-dxa.json

Imaging Example (Bone Density DXA)

{
  "resourceType": "DiagnosticReport",
  "id": "102",
  "text": {
    "status": "generated",
    "div": "<div>\n\t\t\t\n      \n      <h2>DXA BONE DENSITOMETRY</h2>\n\t\t\t\n      \n      <table>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>NAME</td>\n\t\t\t\t\t\n          \n          <td>XXXXXXX</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>DOB</td>\n\t\t\t\t\t\n          \n          <td>10/02/1974</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>REFERRING DR</td>\n\t\t\t\t\t\n          \n          <td>Smith, Jane</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>INDICATIONS</td>\n\t\t\t\t\t\n          \n          <td>Early menopause on estrogen levels. No period  for 18 months</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>PROCEDURE</td>\n\t\t\t\t\t\n          \n          <td>Dual energy x-ray absorptiometry (DEXA)</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\n      \n      </table>\n\t\t\t\n      \n      <h3>Bone Mineral Density</h3>\n\t\t\t\n      \n      <table>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>Scan Type</td>\n\t\t\t\t\t\n          \n          <td>Region</td>\n\t\t\t\t\t\n          \n          <td>Measured</td>\n\t\t\t\t\t\n          \n          <td>Age</td>\n\t\t\t\t\t\n          \n          <td>BMD</td>\n\t\t\t\t\t\n          \n          <td>T-Score</td>\n\t\t\t\t\t\n          \n          <td>Z-Score</td>\n\t\t\t\t\t\n          \n          <td>?BMD(g/cm2)</td>\n\t\t\t\t\t\n          \n          <td>?BMD(%)</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>AP Spine</td>\n\t\t\t\t\t\n          \n          <td>L1-L4</td>\n\t\t\t\t\t\n          \n          <td>17/06/2008</td>\n\t\t\t\t\t\n          \n          <td>34.4</td>\n\t\t\t\t\t\n          \n          <td>1.148 g/cm²</td>\n\t\t\t\t\t\n          \n          <td>-0.4</td>\n\t\t\t\t\t\n          \n          <td>-0.5</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>Left Femur</td>\n\t\t\t\t\t\n          \n          <td>Neck</td>\n\t\t\t\t\t\n          \n          <td>17/06/2008</td>\n\t\t\t\t\t\n          \n          <td>34.4</td>\n\t\t\t\t\t\n          \n          <td>0.891 g/cm²</td>\n\t\t\t\t\t\n          \n          <td>-1.0</td>\n\t\t\t\t\t\n          \n          <td>-0.9</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>Left Femur</td>\n\t\t\t\t\t\n          \n          <td>Total</td>\n\t\t\t\t\t\n          \n          <td>17/06/2008</td>\n\t\t\t\t\t\n          \n          <td>34.4</td>\n\t\t\t\t\t\n          \n          <td>0.887 g/cm²</td>\n\t\t\t\t\t\n          \n          <td>-1.2</td>\n\t\t\t\t\t\n          \n          <td>-1.3</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>Right Femur</td>\n\t\t\t\t\t\n          \n          <td>Neck</td>\n\t\t\t\t\t\n          \n          <td>17/06/2008</td>\n\t\t\t\t\t\n          \n          <td>34.4</td>\n\t\t\t\t\t\n          \n          <td>0.885 g/cm²</td>\n\t\t\t\t\t\n          \n          <td>-1.0</td>\n\t\t\t\t\t\n          \n          <td>-1.0</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\t\n        \n        <tr>\n\t\t\t\t\t\n          \n          <td>Right Femur</td>\n\t\t\t\t\t\n          \n          <td>Total</td>\n\t\t\t\t\t\n          \n          <td>17/06/2008</td>\n\t\t\t\t\t\n          \n          <td>34.4</td>\n\t\t\t\t\t\n          \n          <td>0.867 g/cm²</td>\n\t\t\t\t\t\n          \n          <td>-1.4</td>\n\t\t\t\t\t\n          \n          <td>-1.4</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\t\n          \n          <td>-</td>\n\t\t\t\t\n        \n        </tr>\n\t\t\t\n      \n      </table>\n\t\t\t\n      \n      <p>Assessment:</p>\n\t\t\t\n      \n      <ul>\n\t\t\t\t\n        \n        <li>The Spine L1-L4 BMD is normal.</li>\n\t\t\t\t\n        \n        <li>The Left Femur Neck BMD is in the osteopenic range. Relative fracture risk is about 2.</li>\n\t\t\t\t\n        \n        <li>The Left Femur Total BMD is in the osteopenic range. Relative fracture risk is about 2.</li>\n\t\t\t\t\n        \n        <li>The Right Femur Neck BMD is in the osteopenic range. Relative fracture risk is about 2.</li>\n\t\t\t\t\n        \n        <li>The Right Femur Total BMD is in the osteopenic range. Relative fracture risk is about 2.</li>\n\t\t\t\n      \n      </ul>\n\t\t\t\n      \n      <p>\n\t\t\t\t\n        \n        <b>COMMENT</b>\n\t\t\t\n      \n      </p>\n\t\t\t\n      \n      <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>\n\t\t\t\n      \n      <p>Thank you for your referral.  Dr Peter Ng  17/06/2008</p>\n\t\t\t\n      \n      <pre>\nNote:\nWHO classification of osteoporosis (WHO Technical Report Series 1994: 843)\n- Normal: T-score equal to -1.0 s.d. or higher\n- Osteopenia: T-score  between -1.0 and -2.5 s.d.\n- Osteoporosis: T-score equal to -2.5 s.d. or lower\n- Severe/Established osteoporosis: Osteoporosis with one or more fragility fracture.\nT-score: The number of s.d. from the mean BMD for a gender-matched young adult population.\nZ-score: The number of s.d. from the mean BMD for an age-, weight- and gender-matched population.\nReference 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.\nGE LUNAR PRODIGY DENSITOMETER\n</pre>\n\t\t\n    \n    </div>"
  },
  "contained": [
    {
      "resourceType": "Observation",
      "id": "r1",
      "_id": {
        "fhir_comments": [
          "      Here is one of the measurements above encoded as an observation for example purposes.      "
        ]
      },
      "status": "final",
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "24701-5",
            "display": "Femur DXA Bone density"
          }
        ]
      },
      "subject": {
        "reference": "Patient/pat2"
      },
      "performer": [
        {
          "fhir_comments": [
            "      well, actually. this isn't the patient, but it'll do for now      "
          ],
          "reference": "Organization/1832473e-2fe0-452d-abe9-3cdb9879522f",
          "display": "Acme Imaging Diagnostics"
        }
      ],
      "valueQuantity": {
        "value": 0.887,
        "unit": "g/cm²",
        "system": "http://unitsofmeasure.org",
        "code": "g/cm-2"
      },
      "bodySite": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "71341001:272741003=7771000"
          }
        ]
      }
    }
  ],
  "status": "final",
  "code": {
    "fhir_comments": [
      "      femur, laterality = left      ",
      "      first, various administrative/context stuff      "
    ],
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "38269-7"
      }
    ],
    "text": "DXA BONE DENSITOMETRY"
  },
  "subject": {
    "reference": "Patient/pat2"
  },
  "effectiveDateTime": "2008-06-17",
  "issued": "2008-06-18T09:23:00+10:00",
  "_issued": {
    "fhir_comments": [
      "      all this report is final      "
    ]
  },
  "performer": {
    "fhir_comments": [
      "      well, actually. this isn't the patient, but it'll do for now      "
    ],
    "reference": "Organization/1832473e-2fe0-452d-abe9-3cdb9879522f",
    "display": "Acme Imaging Diagnostics"
  },
  "result": [
    {
      "reference": "#r1"
    }
  ],
  "codedDiagnosis": [
    {
      "fhir_comments": [
        "      the imaging service marks this to help find categories of patient      "
      ],
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "391040000",
          "display": "At risk of osteoporotic fracture"
        }
      ]
    }
  ]
}