HL7 Europe Imaging Report R5, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.1-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/imaging-r5/ and changes regularly. See the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Composition: semi-structured

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{
  "resourceType" : "Composition",
  "id" : "CompositionSemiStructured",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.eu/fhir/imaging-r5/StructureDefinition/CompositionEuImaging"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "extensions"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/event-basedOn",
      "valueReference" : {
        "type" : "ServiceRequest",
        "identifier" : {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-ActClass#v2-0203",
                "code" : "ACSN"
              }
            ]
          },
          "system" : "http://example.org/myhosptital/accessionsystem",
          "value" : "123456789"
        }
      }
    },
    {
      "url" : "http://hl7.eu/fhir/imaging-r5/StructureDefinition/DiagnosticReportEuImagingReferenceExtensionEuImaging",
      "valueReference" : {
        🔗 "reference" : "DiagnosticReport/DiagnosticReportSemiStructured"
      }
    }
  ],
  "identifier" : [
    {
      "system" : "http://example.org/myhosptital/reportidentifiers",
      "value" : "o32u4js8492ff"
    }
  ],
  "version" : "1.0.0",
  "status" : "final",
  "type" : {
    "coding" : [
      {
        "system" : "http://loinc.org",
        "code" : "24802-1",
        "display" : "MR Knee"
      }
    ]
  },
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
          "code" : "RAD",
          "display" : "Radiology"
        }
      ]
    }
  ],
  "subject" : [
    {
      🔗 "reference" : "Patient/PatientSemiStructuredReport"
    }
  ],
  "date" : "2025-05-08",
  "author" : [
    {
      🔗 "reference" : "PractitionerRole/PractitionerRoleSemiStructuredReportAuthor"
    },
    {
      🔗 "reference" : "Organization/OrganizationSemiStructuredReport"
    }
  ],
  "title" : "Radiology Report for the left/right foot study",
  "section" : [
    {
      "title" : "Imaging Study",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "18726-0"
          }
        ]
      },
      "text" : {
        "extension" : [
          {
            "extension" : [
              {
                "url" : "htmlid",
                "valueString" : "study1"
              },
              {
                "url" : "data",
                "valueUri" : "#study1-ref"
              }
            ],
            "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
          },
          {
            "extension" : [
              {
                "url" : "htmlid",
                "valueString" : "study2"
              },
              {
                "url" : "data",
                "valueUri" : "#study2-ref"
              }
            ],
            "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
          }
        ],
        "status" : "generated"
      },
      "entry" : [
        {
          🔗 "id" : "study1-ref",
          "reference" : "ImagingStudy/ImagingStudySemiStructuredReport1"
        },
        {
          🔗 "id" : "study2-ref",
          "reference" : "ImagingStudy/ImagingStudySemiStructuredReport2"
        }
      ]
    },
    {
      "title" : "Order",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "55115-0",
            "display" : "Requested imaging studies information Document"
          }
        ]
      },
      "text" : {
        "status" : "generated"
      },
      "emptyReason" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/list-empty-reason",
            "code" : "nilknown",
            "display" : "Nil Known"
          }
        ]
      }
    },
    {
      "title" : "History",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "11329-0",
            "display" : "History general Narrative - Reported"
          }
        ]
      },
      "text" : {
        "status" : "generated"
      },
      "emptyReason" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/list-empty-reason",
            "code" : "nilknown",
            "display" : "Nil Known"
          }
        ]
      }
    },
    {
      "title" : "Procedure",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "55111-9",
            "display" : "Current imaging procedure descriptions Document"
          }
        ]
      },
      "text" : {
        "status" : "generated"
      },
      "emptyReason" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/list-empty-reason",
            "code" : "unavailable",
            "display" : "Unavailable"
          }
        ]
      }
    },
    {
      "title" : "Comparison",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "18834-2",
            "display" : "Radiology Comparison study (narrative)"
          }
        ]
      },
      "text" : {
        "status" : "generated"
      },
      "emptyReason" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/list-empty-reason",
            "code" : "nilknown",
            "display" : "Nil Known"
          }
        ]
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/note",
          "valueAnnotation" : {
            "id" : "finding-note1",
            "text" : "Linker Fuß:\n  Allenfalls geringe Abflachung des Fußgewölbes und normale Dicke der Plantarfaszie. Regelrechte\n  Artikulation im Rückfuß, Mittelfuß und Vorfußes. Im Großzehengrundgelenk deutliche Verschmälerung des\n  Gelenkspaltes und Ausbildung von subchondralen Geröllzysten sowie deutliche postoperative\n  Veränderungen nach Umstellungsosteotomie. Die Beuge- und Strecksehnen sind intakt."
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/note",
          "valueAnnotation" : {
            "id" : "finding-note2",
            "text" : "Rechter Fuß:\n  Analog zur Gegenseite zeigt sich eine allenfalls geringe Abflachung des Fußgewölbes und unauffällige\n  Plantarfaszie. Normale Artikulation im Rückfuß, Mittelfußes und Vorfußes. Im Seitenvergleich rechts\n  geringere degenerative Veränderungen des Großzehengrundgelenkes. Keine Signalauffälligkeiten an den\n  Beuge- und Strecksehnen."
          }
        }
      ],
      "title" : "Findings",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "59776-5",
            "display" : "Procedure findings Narrative"
          }
        ]
      },
      "text" : {
        "extension" : [
          {
            "extension" : [
              {
                "url" : "htmlid",
                "valueString" : "note1"
              },
              {
                "url" : "data",
                "valueUri" : "#finding-note1"
              }
            ],
            "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
          },
          {
            "extension" : [
              {
                "url" : "htmlid",
                "valueString" : "note2"
              },
              {
                "url" : "data",
                "valueUri" : "#finding-note2"
              }
            ],
            "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
          }
        ],
        "status" : "generated"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/note",
          "valueAnnotation" : {
            "id" : "impression-note",
            "text" : "Beginnende Großzehengrundgelenksarthrose, links mehr als rechts. Z.n. Umstellungsosteotomie des MFK1 links."
          }
        }
      ],
      "title" : "Impression",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "19005-8",
            "display" : "Radiology Imaging study [Impression] (narrative)"
          }
        ]
      },
      "text" : {
        "extension" : [
          {
            "extension" : [
              {
                "url" : "htmlid",
                "valueString" : "note"
              },
              {
                "url" : "data",
                "valueUri" : "#impression-note"
              }
            ],
            "url" : "http://hl7.org/fhir/StructureDefinition/textLink"
          }
        ],
        "status" : "generated"
      }
    },
    {
      "title" : "Recommendations",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "18783-1",
            "display" : "Radiology Study recommendation (narrative)"
          }
        ]
      },
      "text" : {
        "status" : "generated"
      },
      "emptyReason" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/list-empty-reason",
            "code" : "nilknown",
            "display" : "Nil Known"
          }
        ]
      }
    }
  ]
}