<?xml version="1.0" encoding="UTF-8"?><DiagnosticReport xmlns="http://hl7.org/fhir">
  <id value="102"/>
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    <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>
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  <!-- first, various administrative/context stuff -->
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    <text value="DXA BONE DENSITOMETRY"/>
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  <subject>
    <reference value="Patient/pat2"/>
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  <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 -->
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    <display value="Dr Henry Seven"/>
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  <!-- 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>
    <reference value="Observation/bmd"/>
  </result>
  <!-- the imaging service marks this to help find categories of patient -->
  <conclusionCode/>
</DiagnosticReport>