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10.7 Resource BodyStructure - Content

Responsible Owner: Orders and Observations icon Work Group NormativeSecurity Category: Patient Compartments: Patient

Record details about an anatomical structure. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

Note to Balloters for Ballot5: Changes include compatible substantive updates to BodyStructure cardinalities and included-structure detail, plus clarification updates to narrative guidance, examples, search-parameter wording, 5Ws mappings, and artifact-scoped terminology.

Reviewers should pay particular attention to the included-structure changes and the change making BodyStructure.patient optional, because these affect how anatomical and pathological structures can be represented, reused, and tracked.

This resource is referenced from the Diagnostics Module; reviewers should also consider related module-page ballot content when reviewing this resource.

Compatible substantive

  • Cardinality of BodyStructure.includedStructure.morphology relaxed to 0..* so that multiple morphology concepts can be recorded for an included structure. An example has been included to demonstrate usage. FHIR-56262 icon
  • Added BodyStructure.includedStructure.origin to capture the origin of the included structure, backed by a new artifact-scoped codesystem-bodystructure-origin and valueset-bodystructure-origin FHIR-53864 icon
  • Cardinality of BodyStructure.patient relaxed to 0..1, allowing the patient reference to be omitted FHIR-54450 icon

Non-substantive

  • The Boundaries-and-Relationships narrative was rewritten to explain when, and how, other resources should reference BodyStructure FHIR-54843 icon, FHIR-54845 icon, FHIR-54747 icon
  • Added a mammography breast-mass example and linked it from the BodyStructure examples list FHIR-57518 icon, FHIR-54747 icon
  • Updated the BodyStructure Five Ws mapping exceptions FHIR-54961 icon
  • Guidance text for the usage of BodyStructure.active has been clarified FHIR-54873 icon

Changes since 6.0.0-ballot5:

  • FHIR-57928 icon - Added a dermatology example showing facial skin as an included structure with eyelid skin excluded
  • FHIR-57929 icon - Added guidance to BodyStructure.includedStructure and BodyStructure.excludedStructure to avoid specifying the same anatomical area as both included and excluded
  • FHIR-58415 icon - Corrected the BodyStructure.includedStructure.morphology definition to describe the included structure without referencing the removed BodyStructure.location element
  • FHIR-57931 icon - Clarified that a body landmark description locates the corresponding structure
  • FHIR-57930 icon - Corrected a grammatical typo in the clock-face position definition
  • FHIR-57353 icon - Added overall BodyStructure.morphology for a single morphology spanning included structures, clarified the per-structure morphology description, and revised the excluded-structure definition.
  • FHIR-58261 icon - Restored left and right to the included-structure qualifier value set, clarified how qualifier differs from laterality, and updated an example to show both.

10.7.1 Scope and Usage

The BodyStructure resource contains details about an anatomical or pathological structure (e.g. a cyst) and may include patient information, identifiers, text descriptions, images, and spatially relevant characteristics.

BodyStructure is used when a coded concept alone does not provide sufficient detail, identity, persistence, or reuse for the use case. It supports representation of complex anatomical structures and locations using included and excluded structures and can provide additional detail such as laterality, directionality, qualifiers, morphology, images, landmark-based positioning, and spatial references.

Some anatomical structures are discontiguous or consist of multiple related structures. A single BodyStructure instance may represent multiple included structures when they are considered a single anatomical or pathological entity for recording, tracking, or clinical management purposes. Separate BodyStructure instances should be used when structures need to be identified, assessed, tracked, treated, or managed independently over time.

Use BodyStructure.morphology when a single morphology applies across multiple included structures and cannot be assigned to one entry. Use includedStructure.morphology for a morphology specific to an individual included structure.

Use includedStructure.laterality to distinguish a paired structure, such as the left or right breast. Use includedStructure.qualifier to describe a part of a structure, such as an upper region or the left wall of an unpaired organ. Both can be present when they describe different aspects of the same included structure.

The BodyStructure resource supports recording and tracking an anatomic location or structure on a patient outside the context of another resource.

10.7.2 Boundaries and Relationships

A BodyStructure instance is appropriate when the anatomical structure or pathological structures need to be recorded and tracked outside the context of a single resource, reused across resources, or described with additional detail such as laterality, qualifiers, morphology, images, or spatial description.

The bodyStructure element in resources that support it can be used when the resource's code does not fully specify the relevant body structure. As a CodeableReference, it supports both simple coded body structure concepts and references to a BodyStructure instance when additional detail or site-specific identity is needed; repeating elements allow multiple body structures to be represented.

Referencing resources, such as Procedure or Observation, can use one or more BodyStructure instances to identify the relevant structures consistently across multiple records and over time.

Resources that support references to BodyStructure should generally allow multiple references where multiple anatomical or pathological structures may be relevant to the clinical context. A resource may reference multiple BodyStructure instances when the structures are distinct entities that need to be identified or managed independently. A single BodyStructure instance may represent multiple related structures through its includedStructure elements when those structures are treated as a single anatomical or pathological entity.

If a resource's code implies a body structure, any referenced BodyStructure should be consistent with that code and used to provide additional anatomical detail.

10.7.3 References to this Resource

10.7.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. BodyStructure N DomainResource Specific and identified anatomical structure

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ 0..* Identifier Bodystructure identifier

... active ?!Σ 0..1 boolean Whether this record is in active use
... morphology Σ 0..1 CodeableConcept Morphology of the body structure
Binding: SNOMED CT Morphologic Abnormalities (Example)
.... structure Σ 1..1 CodeableConcept Code that represents the included structure
Binding: SNOMED CT Body Structures (Example)
.... laterality 0..1 CodeableConcept Code that represents the included structure laterality
Binding: Bodystructure Laterality (Example)
.... bodyLandmarkOrientation 0..* BackboneElement Landmark relative location

..... landmarkDescription 0..* CodeableConcept Explanation of landmark
Binding: SNOMED CT Body Structures (Example)

..... clockFacePosition 0..* CodeableConcept Clockface orientation
Binding: Bodystructure Body Landmark Clock Face Position (Example)

..... distanceFromLandmark 0..* BackboneElement Landmark relative location

...... device 0..* CodeableReference(Device) Measurement device
Binding: Device Type (Example)

...... value 0..* Quantity Measured distance from body landmark

..... surfaceOrientation 0..* CodeableConcept Relative landmark surface orientation
Binding: Bodystructure Location Qualifier (Preferred)

.... spatialReference 0..* Reference(ImagingSelection) Cartesian reference for structure

.... image 0..* Attachment Image(s) of structural aspects

.... qualifier 0..* CodeableConcept Code that represents the included structure qualifier
Binding: Bodystructure Location Qualifier (Example)

.... morphology Σ 0..* CodeableConcept Structure morphology
Binding: SNOMED CT Morphologic Abnormalities (Example)

.... origin 0..* CodeableConcept Origin of the body structure
Binding: Body Structure Origin Codes (Example)

... excludedStructure 0..* see includedStructure Excluded anatomic locations(s)

... description Σ 0..1 markdown Text description
... image 0..* Attachment Attached images

... patient Σ 0..1 Reference(Patient) Who this is about

doco Documentation for this format icon

UML Diagram (Legend)

BodyStructure (DomainResource)Identifier for this instance of the anatomical structureidentifier : Identifier [0..*]Whether this body structure is in active use (this element modifies the meaning of other elements)active : boolean [0..1]A single morphologic entity that spans multiple anatomical entries in the included structuresmorphology : CodeableConcept [0..1] « null (Strength=Example) SNOMEDCTMorphologicAbnormalit...?? »A summary, characterization or explanation of the body structuredescription : markdown [0..1]Image(s) used to identify aspects of the overall structureimage : Attachment [0..*]The person to which the body site belongspatient : Reference [0..1] « Patient »IncludedStructureCode that represents the included structurestructure : CodeableConcept [1..1] « Codes describing anatomical locations. May include laterality. (Strength=Example)SNOMEDCTBodyStructures?? »Code that distinguishes the side of a paired included structurelaterality : CodeableConcept [0..1] « null (Strength=Example)BodystructureLaterality?? »XY or XYZ-coordinate orientation for structurespatialReference : Reference [0..*] « ImagingSelection »Image(s) used to identify aspects of an included or excluded structureimage : Attachment [0..*]Code that describes a part or region of the included structurequalifier : CodeableConcept [0..*] « null (Strength=Example)BodystructureLocationQualifier?? »The morphology of the included anatomical or pathological structure. This can define both normal and abnormal morphologiesmorphology : CodeableConcept [0..*] « null (Strength=Example) SNOMEDCTMorphologicAbnormalit...?? »The origin of the included body structure, such as autologous, allogeneic, synthetic, or other sourceorigin : CodeableConcept [0..*] « null (Strength=Example)BodyStructureOrigin?? »BodyLandmarkOrientationBody landmark description used as a reference to locate the corresponding structurelandmarkDescription : CodeableConcept [0..*] « null (Strength=Example) SNOMEDCTBodyStructures?? »A description of the direction away from a landmark something is located based on a radial clock dialclockFacePosition : CodeableConcept [0..*] « null (Strength=Example) BodystructureBodyLandmarkCloc...?? »The surface area a body location is in relation to a landmarksurfaceOrientation : CodeableConcept [0..*] « null (Strength=Preferred) BodystructureLocationQualifier? »DistanceFromLandmarkAn instrument, tool, analyzer, etc. used in the measurementdevice : CodeableReference [0..*] « Device; null (Strength=Example)DeviceType?? »The measured distance (e.g., in cm) from a body landmarkvalue : Quantity [0..*]The distance in centimeters a certain observation is made from a body landmarkdistanceFromLandmark[0..*]Body location in relation to a specific body landmark (e.g., a body structure such a navel, scar, or implanted device)bodyLandmarkOrientation[0..*]The anatomical location(s) or region(s) of the specimen, lesion, or body structureincludedStructure[1..*]The anatomical location(s) or region(s) not occupied or represented by the body structure, morphologic entity, or specimenexcludedStructure[0..*]

XML Template

<BodyStructure xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Bodystructure identifier --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this record is in active use -->
 <morphology><!-- 0..1 CodeableConcept Morphology of the body structure --></morphology>
 <includedStructure>  <!-- 1..* Included anatomic location(s) -->
  <structure><!-- 1..1 CodeableConcept Code that represents the included structure --></structure>
  <laterality><!-- 0..1 CodeableConcept Code that represents the included structure laterality --></laterality>
  <bodyLandmarkOrientation>  <!-- 0..* Landmark relative location -->
   <landmarkDescription><!-- 0..* CodeableConcept Explanation of landmark --></landmarkDescription>
   <clockFacePosition><!-- 0..* CodeableConcept Clockface orientation --></clockFacePosition>
   <distanceFromLandmark>  <!-- 0..* Landmark relative location -->
    <device><!-- 0..* CodeableReference(Device) Measurement device --></device>
    <value><!-- 0..* Quantity Measured distance from body landmark --></value>
   </distanceFromLandmark>
   <surfaceOrientation><!-- 0..* CodeableConcept Relative landmark surface orientation --></surfaceOrientation>
  </bodyLandmarkOrientation>
  <spatialReference><!-- 0..* Reference(ImagingSelection) Cartesian reference for structure --></spatialReference>
  <image><!-- 0..* Attachment Image(s) of structural aspects --></image>
  <qualifier><!-- 0..* CodeableConcept Code that represents the included structure qualifier --></qualifier>
  <morphology><!-- 0..* CodeableConcept Structure morphology --></morphology>
  <origin><!-- 0..* CodeableConcept Origin of the body structure --></origin>
 </includedStructure>
 <excludedStructure><!-- 0..* Content as for BodyStructure.includedStructure Excluded anatomic locations(s) --></excludedStructure>
 <description value="[markdown]"/><!-- 0..1 Text description -->
 <image><!-- 0..* Attachment Attached images --></image>
 <patient><!-- 0..1 Reference(Patient) Who this is about --></patient>
</BodyStructure>

JSON Template

{doco
  "resourceType" : "BodyStructure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Bodystructure identifier
  "active" : <boolean>, // Whether this record is in active use
  "morphology" : { CodeableConcept }, // Morphology of the body structure
  "includedStructure" : [{ // R!  Included anatomic location(s)
    "structure" : { CodeableConcept }, // R!  Code that represents the included structure
    "laterality" : { CodeableConcept }, // Code that represents the included structure laterality
    "bodyLandmarkOrientation" : [{ // Landmark relative location
      "landmarkDescription" : [{ CodeableConcept }], // Explanation of landmark
      "clockFacePosition" : [{ CodeableConcept }], // Clockface orientation
      "distanceFromLandmark" : [{ // Landmark relative location
        "device" : [{ CodeableReference(Device) }], // Measurement device
        "value" : [{ Quantity }] // Measured distance from body landmark
      }],
      "surfaceOrientation" : [{ CodeableConcept }] // Relative landmark surface orientation
    }],
    "spatialReference" : [{ Reference(ImagingSelection) }], // Cartesian reference for structure
    "image" : [{ Attachment }], // Image(s) of structural aspects
    "qualifier" : [{ CodeableConcept }], // Code that represents the included structure qualifier
    "morphology" : [{ CodeableConcept }], // Structure morphology
    "origin" : [{ CodeableConcept }] // Origin of the body structure
  }],
  "excludedStructure" : [{ Content as for BodyStructure.includedStructure }], // Excluded anatomic locations(s)
  "description" : "<markdown>", // Text description
  "image" : [{ Attachment }], // Attached images
  "patient" : { Reference(Patient) } // Who this is about
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:BodyStructure;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Bodystructure identifier
  fhir:active [ boolean ] ; # 0..1 Whether this record is in active use
  fhir:morphology [ CodeableConcept ] ; # 0..1 Morphology of the body structure
  fhir:includedStructure ( [ # 1..* Included anatomic location(s)
    fhir:structure [ CodeableConcept ] ; # 1..1 Code that represents the included structure
    fhir:laterality [ CodeableConcept ] ; # 0..1 Code that represents the included structure laterality
    fhir:bodyLandmarkOrientation ( [ # 0..* Landmark relative location
      fhir:landmarkDescription  ( [ CodeableConcept ] ... ) ; # 0..* Explanation of landmark
      fhir:clockFacePosition  ( [ CodeableConcept ] ... ) ; # 0..* Clockface orientation
      fhir:distanceFromLandmark ( [ # 0..* Landmark relative location
        fhir:device  ( [ CodeableReference(Device) ] ... ) ; # 0..* Measurement device
        fhir:value  ( [ Quantity ] ... ) ; # 0..* Measured distance from body landmark
      ] ... ) ;
      fhir:surfaceOrientation  ( [ CodeableConcept ] ... ) ; # 0..* Relative landmark surface orientation
    ] ... ) ;
    fhir:spatialReference  ( [ Reference(ImagingSelection) ] ... ) ; # 0..* Cartesian reference for structure
    fhir:image  ( [ Attachment ] ... ) ; # 0..* Image(s) of structural aspects
    fhir:qualifier  ( [ CodeableConcept ] ... ) ; # 0..* Code that represents the included structure qualifier
    fhir:morphology  ( [ CodeableConcept ] ... ) ; # 0..* Structure morphology
    fhir:origin  ( [ CodeableConcept ] ... ) ; # 0..* Origin of the body structure
  ] ... ) ;
  fhir:excludedStructure  ( [ See BodyStructure.includedStructure ] ... ) ; # 0..* Excluded anatomic locations(s)
  fhir:description [ markdown ] ; # 0..1 Text description
  fhir:image  ( [ Attachment ] ... ) ; # 0..* Attached images
  fhir:patient [ Reference(Patient) ] ; # 0..1 Who this is about
]

Changes from R5 to R6

BodyStructure
BodyStructure.includedStructure.image
  • Added Element
BodyStructure.includedStructure.morphology
  • Moved from BodyStructure to BodyStructure.includedStructure
  • Max Cardinality changed from 1 to *
BodyStructure.includedStructure.origin
  • Added Element
BodyStructure.patient
  • Min Cardinality changed from 1 to 0

Changes from R4 and R4B to R6

BodyStructure
BodyStructure.includedStructure
  • Added Mandatory Element
BodyStructure.includedStructure.structure
  • Moved from BodyStructure.location to structure
  • Min Cardinality changed from 0 to 1
BodyStructure.includedStructure.laterality
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.landmarkDescription
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.clockFacePosition
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.device
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.value
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.surfaceOrientation
  • Added Element
BodyStructure.includedStructure.spatialReference
  • Added Element
BodyStructure.includedStructure.image
  • Added Element
BodyStructure.includedStructure.qualifier
  • Moved from BodyStructure.locationQualifier to qualifier
BodyStructure.includedStructure.morphology
  • Moved from BodyStructure to BodyStructure.includedStructure
  • Max Cardinality changed from 1 to *
BodyStructure.includedStructure.origin
  • Added Element
BodyStructure.excludedStructure
  • Added Element
BodyStructure.description
  • Type changed from string to markdown
BodyStructure.patient
  • Min Cardinality changed from 1 to 0

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Structure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. BodyStructure N DomainResource Specific and identified anatomical structure

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ 0..* Identifier Bodystructure identifier

... active ?!Σ 0..1 boolean Whether this record is in active use
... morphology Σ 0..1 CodeableConcept Morphology of the body structure
Binding: SNOMED CT Morphologic Abnormalities (Example)
.... structure Σ 1..1 CodeableConcept Code that represents the included structure
Binding: SNOMED CT Body Structures (Example)
.... laterality 0..1 CodeableConcept Code that represents the included structure laterality
Binding: Bodystructure Laterality (Example)
.... bodyLandmarkOrientation 0..* BackboneElement Landmark relative location

..... landmarkDescription 0..* CodeableConcept Explanation of landmark
Binding: SNOMED CT Body Structures (Example)

..... clockFacePosition 0..* CodeableConcept Clockface orientation
Binding: Bodystructure Body Landmark Clock Face Position (Example)

..... distanceFromLandmark 0..* BackboneElement Landmark relative location

...... device 0..* CodeableReference(Device) Measurement device
Binding: Device Type (Example)

...... value 0..* Quantity Measured distance from body landmark

..... surfaceOrientation 0..* CodeableConcept Relative landmark surface orientation
Binding: Bodystructure Location Qualifier (Preferred)

.... spatialReference 0..* Reference(ImagingSelection) Cartesian reference for structure

.... image 0..* Attachment Image(s) of structural aspects

.... qualifier 0..* CodeableConcept Code that represents the included structure qualifier
Binding: Bodystructure Location Qualifier (Example)

.... morphology Σ 0..* CodeableConcept Structure morphology
Binding: SNOMED CT Morphologic Abnormalities (Example)

.... origin 0..* CodeableConcept Origin of the body structure
Binding: Body Structure Origin Codes (Example)

... excludedStructure 0..* see includedStructure Excluded anatomic locations(s)

... description Σ 0..1 markdown Text description
... image 0..* Attachment Attached images

... patient Σ 0..1 Reference(Patient) Who this is about

doco Documentation for this format icon

UML Diagram (Legend)

BodyStructure (DomainResource)Identifier for this instance of the anatomical structureidentifier : Identifier [0..*]Whether this body structure is in active use (this element modifies the meaning of other elements)active : boolean [0..1]A single morphologic entity that spans multiple anatomical entries in the included structuresmorphology : CodeableConcept [0..1] « null (Strength=Example) SNOMEDCTMorphologicAbnormalit...?? »A summary, characterization or explanation of the body structuredescription : markdown [0..1]Image(s) used to identify aspects of the overall structureimage : Attachment [0..*]The person to which the body site belongspatient : Reference [0..1] « Patient »IncludedStructureCode that represents the included structurestructure : CodeableConcept [1..1] « Codes describing anatomical locations. May include laterality. (Strength=Example)SNOMEDCTBodyStructures?? »Code that distinguishes the side of a paired included structurelaterality : CodeableConcept [0..1] « null (Strength=Example)BodystructureLaterality?? »XY or XYZ-coordinate orientation for structurespatialReference : Reference [0..*] « ImagingSelection »Image(s) used to identify aspects of an included or excluded structureimage : Attachment [0..*]Code that describes a part or region of the included structurequalifier : CodeableConcept [0..*] « null (Strength=Example)BodystructureLocationQualifier?? »The morphology of the included anatomical or pathological structure. This can define both normal and abnormal morphologiesmorphology : CodeableConcept [0..*] « null (Strength=Example) SNOMEDCTMorphologicAbnormalit...?? »The origin of the included body structure, such as autologous, allogeneic, synthetic, or other sourceorigin : CodeableConcept [0..*] « null (Strength=Example)BodyStructureOrigin?? »BodyLandmarkOrientationBody landmark description used as a reference to locate the corresponding structurelandmarkDescription : CodeableConcept [0..*] « null (Strength=Example) SNOMEDCTBodyStructures?? »A description of the direction away from a landmark something is located based on a radial clock dialclockFacePosition : CodeableConcept [0..*] « null (Strength=Example) BodystructureBodyLandmarkCloc...?? »The surface area a body location is in relation to a landmarksurfaceOrientation : CodeableConcept [0..*] « null (Strength=Preferred) BodystructureLocationQualifier? »DistanceFromLandmarkAn instrument, tool, analyzer, etc. used in the measurementdevice : CodeableReference [0..*] « Device; null (Strength=Example)DeviceType?? »The measured distance (e.g., in cm) from a body landmarkvalue : Quantity [0..*]The distance in centimeters a certain observation is made from a body landmarkdistanceFromLandmark[0..*]Body location in relation to a specific body landmark (e.g., a body structure such a navel, scar, or implanted device)bodyLandmarkOrientation[0..*]The anatomical location(s) or region(s) of the specimen, lesion, or body structureincludedStructure[1..*]The anatomical location(s) or region(s) not occupied or represented by the body structure, morphologic entity, or specimenexcludedStructure[0..*]

XML Template

<BodyStructure xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Bodystructure identifier --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this record is in active use -->
 <morphology><!-- 0..1 CodeableConcept Morphology of the body structure --></morphology>
 <includedStructure>  <!-- 1..* Included anatomic location(s) -->
  <structure><!-- 1..1 CodeableConcept Code that represents the included structure --></structure>
  <laterality><!-- 0..1 CodeableConcept Code that represents the included structure laterality --></laterality>
  <bodyLandmarkOrientation>  <!-- 0..* Landmark relative location -->
   <landmarkDescription><!-- 0..* CodeableConcept Explanation of landmark --></landmarkDescription>
   <clockFacePosition><!-- 0..* CodeableConcept Clockface orientation --></clockFacePosition>
   <distanceFromLandmark>  <!-- 0..* Landmark relative location -->
    <device><!-- 0..* CodeableReference(Device) Measurement device --></device>
    <value><!-- 0..* Quantity Measured distance from body landmark --></value>
   </distanceFromLandmark>
   <surfaceOrientation><!-- 0..* CodeableConcept Relative landmark surface orientation --></surfaceOrientation>
  </bodyLandmarkOrientation>
  <spatialReference><!-- 0..* Reference(ImagingSelection) Cartesian reference for structure --></spatialReference>
  <image><!-- 0..* Attachment Image(s) of structural aspects --></image>
  <qualifier><!-- 0..* CodeableConcept Code that represents the included structure qualifier --></qualifier>
  <morphology><!-- 0..* CodeableConcept Structure morphology --></morphology>
  <origin><!-- 0..* CodeableConcept Origin of the body structure --></origin>
 </includedStructure>
 <excludedStructure><!-- 0..* Content as for BodyStructure.includedStructure Excluded anatomic locations(s) --></excludedStructure>
 <description value="[markdown]"/><!-- 0..1 Text description -->
 <image><!-- 0..* Attachment Attached images --></image>
 <patient><!-- 0..1 Reference(Patient) Who this is about --></patient>
</BodyStructure>

JSON Template

{doco
  "resourceType" : "BodyStructure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Bodystructure identifier
  "active" : <boolean>, // Whether this record is in active use
  "morphology" : { CodeableConcept }, // Morphology of the body structure
  "includedStructure" : [{ // R!  Included anatomic location(s)
    "structure" : { CodeableConcept }, // R!  Code that represents the included structure
    "laterality" : { CodeableConcept }, // Code that represents the included structure laterality
    "bodyLandmarkOrientation" : [{ // Landmark relative location
      "landmarkDescription" : [{ CodeableConcept }], // Explanation of landmark
      "clockFacePosition" : [{ CodeableConcept }], // Clockface orientation
      "distanceFromLandmark" : [{ // Landmark relative location
        "device" : [{ CodeableReference(Device) }], // Measurement device
        "value" : [{ Quantity }] // Measured distance from body landmark
      }],
      "surfaceOrientation" : [{ CodeableConcept }] // Relative landmark surface orientation
    }],
    "spatialReference" : [{ Reference(ImagingSelection) }], // Cartesian reference for structure
    "image" : [{ Attachment }], // Image(s) of structural aspects
    "qualifier" : [{ CodeableConcept }], // Code that represents the included structure qualifier
    "morphology" : [{ CodeableConcept }], // Structure morphology
    "origin" : [{ CodeableConcept }] // Origin of the body structure
  }],
  "excludedStructure" : [{ Content as for BodyStructure.includedStructure }], // Excluded anatomic locations(s)
  "description" : "<markdown>", // Text description
  "image" : [{ Attachment }], // Attached images
  "patient" : { Reference(Patient) } // Who this is about
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:BodyStructure;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Bodystructure identifier
  fhir:active [ boolean ] ; # 0..1 Whether this record is in active use
  fhir:morphology [ CodeableConcept ] ; # 0..1 Morphology of the body structure
  fhir:includedStructure ( [ # 1..* Included anatomic location(s)
    fhir:structure [ CodeableConcept ] ; # 1..1 Code that represents the included structure
    fhir:laterality [ CodeableConcept ] ; # 0..1 Code that represents the included structure laterality
    fhir:bodyLandmarkOrientation ( [ # 0..* Landmark relative location
      fhir:landmarkDescription  ( [ CodeableConcept ] ... ) ; # 0..* Explanation of landmark
      fhir:clockFacePosition  ( [ CodeableConcept ] ... ) ; # 0..* Clockface orientation
      fhir:distanceFromLandmark ( [ # 0..* Landmark relative location
        fhir:device  ( [ CodeableReference(Device) ] ... ) ; # 0..* Measurement device
        fhir:value  ( [ Quantity ] ... ) ; # 0..* Measured distance from body landmark
      ] ... ) ;
      fhir:surfaceOrientation  ( [ CodeableConcept ] ... ) ; # 0..* Relative landmark surface orientation
    ] ... ) ;
    fhir:spatialReference  ( [ Reference(ImagingSelection) ] ... ) ; # 0..* Cartesian reference for structure
    fhir:image  ( [ Attachment ] ... ) ; # 0..* Image(s) of structural aspects
    fhir:qualifier  ( [ CodeableConcept ] ... ) ; # 0..* Code that represents the included structure qualifier
    fhir:morphology  ( [ CodeableConcept ] ... ) ; # 0..* Structure morphology
    fhir:origin  ( [ CodeableConcept ] ... ) ; # 0..* Origin of the body structure
  ] ... ) ;
  fhir:excludedStructure  ( [ See BodyStructure.includedStructure ] ... ) ; # 0..* Excluded anatomic locations(s)
  fhir:description [ markdown ] ; # 0..1 Text description
  fhir:image  ( [ Attachment ] ... ) ; # 0..* Attached images
  fhir:patient [ Reference(Patient) ] ; # 0..1 Who this is about
]

Changes from R5 to R6

BodyStructure
BodyStructure.includedStructure.image
  • Added Element
BodyStructure.includedStructure.morphology
  • Moved from BodyStructure to BodyStructure.includedStructure
  • Max Cardinality changed from 1 to *
BodyStructure.includedStructure.origin
  • Added Element
BodyStructure.patient
  • Min Cardinality changed from 1 to 0

Changes from R4 and R4B to R6

BodyStructure
BodyStructure.includedStructure
  • Added Mandatory Element
BodyStructure.includedStructure.structure
  • Moved from BodyStructure.location to structure
  • Min Cardinality changed from 0 to 1
BodyStructure.includedStructure.laterality
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.landmarkDescription
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.clockFacePosition
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.device
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.value
  • Added Element
BodyStructure.includedStructure.bodyLandmarkOrientation.surfaceOrientation
  • Added Element
BodyStructure.includedStructure.spatialReference
  • Added Element
BodyStructure.includedStructure.image
  • Added Element
BodyStructure.includedStructure.qualifier
  • Moved from BodyStructure.locationQualifier to qualifier
BodyStructure.includedStructure.morphology
  • Moved from BodyStructure to BodyStructure.includedStructure
  • Max Cardinality changed from 1 to *
BodyStructure.includedStructure.origin
  • Added Element
BodyStructure.excludedStructure
  • Added Element
BodyStructure.description
  • Type changed from string to markdown
BodyStructure.patient
  • Min Cardinality changed from 1 to 0

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis, and See the Extensions for this resource.

10.7.4.1 Terminology Bindings

Path ValueSet Type Documentation
BodyStructure.morphology SNOMEDCTMorphologicAbnormalities Example

This value set includes all codes from SNOMED CT icon where concept is-a 118956008 (Body structure, altered from its original anatomical structure (morphologic abnormality)).
BodyStructure.includedStructure.structure SNOMEDCTBodyStructures Example

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).
BodyStructure.includedStructure.laterality BodystructureLaterality Example

SNOMED-CT concepts modifying the laterality of the anatomic location
BodyStructure.includedStructure.bodyLandmarkOrientation.landmarkDescription SNOMEDCTBodyStructures Example

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).
BodyStructure.includedStructure.bodyLandmarkOrientation.clockFacePosition BodystructureBodyLandmarkClockFacePosition Example

Select SNOMED CT codes. A set of codes that describe a things orientation based on a hourly positions of a clock face.
BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.device DeviceType Example

Codes used to identify medical devices. Includes concepts from SNOMED CT (http://www.snomed.org/) where concept is-a 49062001 (Device) and is provided as a suggestive example.
BodyStructure.includedStructure.bodyLandmarkOrientation.surfaceOrientation BodystructureLocationQualifier Preferred

SNOMED-CT concepts modifying the anatomic location
BodyStructure.includedStructure.qualifier BodystructureLocationQualifier Example

SNOMED-CT concepts modifying the anatomic location
BodyStructure.includedStructure.morphology SNOMEDCTMorphologicAbnormalities Example

This value set includes all codes from SNOMED CT icon where concept is-a 118956008 (Body structure, altered from its original anatomical structure (morphologic abnormality)).
BodyStructure.includedStructure.origin BodyStructureOrigin (a valid code from http://hl7.org/fhir/bodystructure-origin) Example

Example value set for codes describing the origin of a body structure.

10.7.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
excluded-structure token The excluded body structure(s) BodyStructure.excludedStructure.structure
identifier token The unique id for the BodyStructure BodyStructure.identifier 55 Resources
included-structure token The included body structure(s) BodyStructure.includedStructure.structure
morphology token The morphology of the overall body structure or an included structure BodyStructure.morphology | BodyStructure.includedStructure.morphology
patient reference The patient referenced for the identified body structure BodyStructure.patient
(Patient)		 57 Resources