OET Writing practice · Medicine
ACL rupture with ongoing knee instability – orthopaedic surgeon
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your referral letter in 40 minutes, about 180–200 words in the body.
Write this letter and get feedback
Case notes
MEDICINE — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 09/09/2026 You are a GP at Brookside Medical Practice, 30 Market Square, Elmstead. Patient: Mr Nikos Papadopoulos, DOB 12/12/2002 (23 yrs) Social background: - Secondary school PE teacher (since 09/2025) - Semi-professional footballer (midfielder); club hoping he returns this season - Lives with 2 friends in 2nd-floor flat, no lift - Non-smoker. Alcohol approx. 10 units/week (weekends) - Holiday to Crete booked for 20/10/2026 Medical history: - Childhood asthma, resolved; no inhalers - Fractured L wrist (2016), treated conservatively - Tattoo R shoulder (2024) - Medications: nil regular; ibuprofen 400 mg PRN - NKDA Consultation notes: 06/07/2026 - Injured R knee 04/07 during football match: twisted on planted foot, heard a "pop", unable to continue playing - Knee swollen within 1–2 hrs - X-ray at urgent treatment centre (04/07): no fracture - O/E: large effusion, ROM 10–80°, diffuse tenderness. Lachman difficult to assess (guarding). Able to weight-bear - Plan: ice, elevation, crutches; ibuprofen 400 mg TDS with food; physiotherapy referral; review 4 weeks 03/08/2026 - Swelling much reduced; walking without crutches - Knee "gave way" twice when turning quickly - Physio since 15/07 (quadriceps strengthening), weekly - O/E: small effusion. ROM 0–130°. Lachman positive, soft end point. Anterior drawer positive. Pivot shift not tolerated. Medial joint line tenderness; McMurray's test equivocal - Imp: ?ACL rupture. MRI R knee requested 27/08/2026 MRI R knee: - Complete mid-substance ACL rupture - Vertical longitudinal tear, posterior horn of medial meniscus - Bone bruising lateral femoral condyle and posterior lateral tibial plateau - MCL, LCL, PCL intact 09/09/2026 - 8 weeks' physio: quadriceps strength improved, full ROM - Ongoing instability: 4 episodes of giving way in 3 weeks, incl. descending stairs at school and during PE lesson - Knee "locked" on 05/09, released itself after a few minutes; medial knee pain since - O/E: mild effusion, medial joint line tenderness, Lachman positive - Keen for surgery; wants to return to football; worried about time off work - Off football; teaching duties modified (no demonstrations) - Sore throat × 3 days, viral; advised fluids and paracetamol Plan: - Referral to orthopaedics for consideration of ACL reconstruction ± meniscal repair - Continue physiotherapy; hinged knee brace for work - Paracetamol PRN; avoid pivoting sports - Fit note: modified duties Writing Task: Using the information in the case notes, write a letter to Mr Alistair Crane, Consultant Orthopaedic Surgeon, Knee Clinic, Westgate Hospital, 150 Westgate Road, Elmstead, referring Mr Papadopoulos for surgical assessment. In your answer: - Expand the relevant notes into complete sentences - Do not use note form - Use letter format The body of the letter should be approximately 180–200 words.
How to approach this referral letter
- The reader has never met the patient. State the reason for referral, and how urgent it is, in the first paragraph.
- Select the history, findings and investigation results that support the referral, and group them by topic rather than by date.
- End with what you are asking the reader to do, and any action you have already taken.
Members also get the model answer, the note-selection table and task-specific tips for this task.