<?xml version=“1.0” encoding=“UTF-8”?><DiagnosticReport xmlns=“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 Peter Ng  17/06/2008</p>

    <pre>

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

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>
<contained>
  <Observation>
  <!--      Here is one of the measurements above encoded as an observation for example purposes.      -->
    <id value="r1"/>
    <status value="final"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="24701-5"/>
        <display value="Femur DXA Bone density"/>
      </coding>
    </code>
    <subject>
      <reference value="Patient/pat2"/>
    </subject>
  <!--      well, actually. this isn't the patient, but it'll do for now      -->
    <performer>
      <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
      <display value="Acme Imaging Diagnostics"/>
    </performer>
    <valueQuantity>
      <value value="0.887"/>
      <unit value="g/cm²"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="g/cm-2"/>
    </valueQuantity>
    <bodySite>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="71341001:272741003=7771000"/>
      </coding>
    </bodySite>
  </Observation>
</contained>
<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="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
  <display value="Acme Imaging Diagnostics"/>
</performer>
<result>
  <reference value="#r1"/>
</result>

<!– the imaging service marks this to help find categories of patient –>

<codedDiagnosis>
  <coding>
    <system value="http://snomed.info/sct"/>
    <code value="391040000"/>
    <display value="At risk of osteoporotic fracture"/>
  </coding>
</codedDiagnosis>

</DiagnosticReport>