OET experts since 2004

Occupational English Test

Writing Test-Physiotherapists
Time allowed: 40 minutes

Read the case notes below and complete the writing task which follows.

Patient Surname: Lopez

details
Given Names: Adam

Age:38

 Social History: Business man, who was normally very active and
enjoyed playing rugby socially and running regularly.

 Past Medical History: No medical problems of note.

 General health: Good. No cardiovascular nor respiratory problems,

no family history of lower back pain, arthritis, diabetes, epilepsy

 Drug history: Due to the severity of his symptoms, his GP had

prescribed strong pain-killers and muscle relaxants.

Patient A sudden unexplained episode of lower back pain and leg pain, that started
history 8 weeks ago. He reported a history of 1-2 episodes of localised lower back
pain and occasional low-grade leg pain, but nothing ever of this magnitude.

Reason for 12.06. 2013: Presented with an acute onset of severe lower back pain, an
presenting extremely common injury

Post injury Subjective Questioning

 Problem: Constant, unremitting lower back pain, with shooting pain

into the left leg from buttock to heel. He also reported the presence of
pins and needles in his heel.

 Aggravating factors: Any static position aggravated his back and leg
pain if sustained for over 10-15 minutes.

 Easing factors: There was nothing that he could do to ease his

symptoms.
24hrs: He reported difficulty sleeping, but no significant difference
pattern to his symptoms.

 Special Questions to Exclude Serious Pathology: No alterations to

bladder and bowel function, no sudden unexplained weight loss, no
night-time fever/ malaise, no pins and needles/ numbness in groin
region, no significant loss of leg strength.

This material is created by Sameh Mekail and is for the sole use of OET course participants at Trident Training and Education
Services, Egypt. (oet.trident.egypt@gmail.com) +201065223338. Please DO NOT share with others without a written permission
 OET experts since 2004

Objective Examination

 Observation: Unable to maintain any position for longer than 1-2

minutes Active movements: (Patient performed) Restricted and painful
in all planes, especially flexion, which reproduced both back and leg
symptoms.
 Passive movements: (Physiotherapist performed) severe muscle spasm
prevented an accurate assessment of segmental spine movement
 Palpation: Local tenderness at the distal two joints of the Lumbar spine
(L4/5), with widespread muscular spasm. Palpation of L4/5 elicited left
leg symptoms.

 Neurological Tests: Reflex testing, sensory and motor testing was

normal and symmetrical side to side. There was evidence of significant
sciatic nerve irritation when stretched.
 Analysis of Pathology: intervertebral disc prolapse at L4/5, causing
compression to the sciatic nerve root and leg symptoms.
 Assessment: sequestration

Plan: Immediate referral to an Orthopaedic Consultant in Northampton.

Writing Task

Using the information in the case notes, write a letter of referral to Dr. Tim Sherwood, Consultant, Spinal
Injury (Northampton Hospital at 280 Princeton Rd., Northampton 6608) requesting surgical opinion.

This material is created by Sameh Mekail and is for the sole use of OET course participants at Trident Training and Education
Services, Egypt. (oet.trident.egypt@gmail.com) +201065223338. Please DO NOT share with others without a written permission