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Imaging Example (Bone Density DXA)
{
"resourceType": "DiagnosticReport",
"text": {
"status": "generated",
"div": "<div> \n <h2>DXA BONE DENSITOMETRY</h2>\n \n <table>\n <tr><td>NAME</td><td>XXXXXXX</td></tr>\n <tr><td>DOB</td><td>10/02/1974</td></tr>\n <tr><td>REFERRING DR</td><td>Smith, Jane</td></tr>\n <tr><td>INDICATIONS</td><td>Early menopause on estrogen levels. No period for 18 months</td></tr>\n <tr><td>PROCEDURE</td><td>Dual energy x-ray absorptiometry (DEXA)</td></tr>\n </table>\n\n <h3>Bone Mineral Density</h3>\n <table>\n <tr>\n <td>Scan Type</td>\n <td>Region</td>\n <td>Measured</td>\n <td>Age</td>\n <td>BMD</td>\n <td>T-Score</td>\n <td>Z-Score</td>\n <td>ΔBMD(g/cm2)</td>\n <td>ΔBMD(%)</td>\n </tr>\n\n <tr>\n <td>AP Spine</td>\n <td>L1-L4</td>\n <td>17/06/2008</td>\n <td>34.4</td>\n <td>1.148 g/cm²</td>\n <td>-0.4</td>\n <td>-0.5</td>\n <td>-</td>\n <td>-</td>\n </tr>\n\n <tr>\n <td>Left Femur</td>\n <td>Neck</td>\n <td>17/06/2008</td>\n <td>34.4</td>\n <td>0.891 g/cm²</td>\n <td>-1.0</td>\n <td>-0.9</td>\n <td>-</td>\n <td>-</td>\n </tr>\n\n <tr>\n <td>Left Femur</td>\n <td>Total</td>\n <td>17/06/2008</td>\n <td>34.4</td>\n <td>0.887 g/cm²</td>\n <td>-1.2</td>\n <td>-1.3</td>\n <td>-</td>\n <td>-</td>\n </tr>\n\t\t\t\t\t\t\t\n <tr>\n <td>Right Femur</td>\n <td>Neck</td>\n <td>17/06/2008</td>\n <td>34.4</td>\n <td>0.885 g/cm²</td>\n <td>-1.0</td>\n <td>-1.0</td>\n <td>-</td>\n <td>-</td>\n </tr>\n \n <tr>\n <td>Right Femur</td>\n <td>Total</td>\n <td>17/06/2008</td>\n <td>34.4</td>\n <td>0.867 g/cm²</td>\n <td>-1.4</td>\n <td>-1.4</td>\n <td>-</td>\n <td>-</td>\n </tr>\n </table>\n\n <p>Assessment:</p>\n <ul>\n <li>The Spine L1-L4 BMD is normal.</li>\n <li>The Left Femur Neck BMD is in the osteopenic range. Relative fracture risk is about 2.</li>\n <li>The Left Femur Total BMD is in the osteopenic range. Relative fracture risk is about 2.</li>\n <li>The Right Femur Neck BMD is in the osteopenic range. Relative fracture risk is about 2.</li>\n <li>The Right Femur Total BMD is in the osteopenic range. Relative fracture risk is about 2.</li>\n </ul>\n \n <p><b>COMMENT</b></p>\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 \n <p>Thank you for your referral. Dr Peter Ng 17/06/2008</p>\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.\n\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.\n\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.\n\nGE LUNAR PRODIGY DENSITOMETER\n</pre> \n </div>"
},
"contained": [
{
"resourceType": "Observation",
"id": "r1",
"name": {
"coding": [
{
"system": "http://loinc.org",
"code": "24701-5",
"display": "Femur DXA Bone density"
}
]
},
"valueQuantity": {
"value": 0.887,
"units": "g/cm²",
"system": "http://unitsofmeasure.org",
"code": "g/cm-2"
},
"status": "final",
"reliability": "ok",
"bodySite": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "71341001:272741003=7771000"
}
]
}
}
],
"name": {
"coding": [
{
"system": "http://loinc.org",
"code": "38269-7"
}
],
"text": "DXA BONE DENSITOMETRY"
},
"status": "final",
"issued": "2008-06-18T09:23:00+10:00",
"subject": {
"reference": "Patient/pat2"
},
"performer": {
"reference": "Organization/1832473e-2fe0-452d-abe9-3cdb9879522f",
"display": "Acme Imaging Diagnostics"
},
"diagnosticDateTime": "2008-06-17",
"result": [
{
"reference": "#r1"
}
],
"codedDiagnosis": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "391040000",
"display": "At risk of osteoporotic fracture"
}
]
}
]
}