<?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/cm&#xB2;</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/cm&#xB2;</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/cm&#xB2;</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/cm&#xB2;</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/cm&#xB2;</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)

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>
        <!--  putting in the role and actor here to iluustrate how these elements are used -->
        <role>
                <coding>
                        <system value="http://snomed.info/sct"/>
                        <code value="66862007"/>
                        <display value="Radiologist"/>
                </coding>
                <text value="Radiologist"/>
        </role>
        <actor>
                <reference value="Practitioner/3ad0687e-f477-468c-afd5-fcc2bf897809"/>
                <display value="Dr Henry Seven"/>
        </actor>

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

</DiagnosticReport>