Problem: neuro, spine, paediatric and safeguarding referrals each carry extra rules — windows, red flags, consent complexity, documentation standards — and writers apply routine shapes to special cases. Answer in brief: a five-paragraph skeleton (question, history, now, special considerations, request) flexes across all four with one specialist paragraph each. This guide teaches the flex with a worked stroke-imaging referral, and OET Writing for Radiographers — Course 2 trains neuroimaging, spine, paediatric and safeguarding letters across 14 topic sections.
The five-paragraph skeleton
P1 the imaging question with urgency. P2 focused history. P3 today’s findings. P4 special considerations (window eligibility, red-flag screen, consent/sedation needs, safeguarding documentation). P5 precise request with timeframe and forwarding plan. The fourth paragraph is what separates special cases from routine ones — writers who skip it produce competent letters for the wrong situation.
Neuroimaging: stroke, TIA, seizure
Onset-to-now timeline, deficit description, glucose exclusion, prior imaging baseline, thrombolysis-window candidacy with the exact onset time restated. First-seizure letters add: witnessed account quality, provoking factors sought (alcohol, drugs, sleep deprivation), driving implications stated. The window question must be explicit — “within thrombolysis window” or “outside window; for aetiology and secondary prevention”.
Train special-case letters supervised? The full OET Writing for Radiographers — Course 2 covers neuroimaging, spine, paediatric and safeguarding letters with the five-paragraph skeleton across 14 topic sections with 47 lessons and mock tests. Explore the course →
Spine letters: red-flag screen first
Saddle numbness, bladder/bowel change, sexual dysfunction, night pain, weight loss, IV drug use, immunosuppression, known malignancy — screened explicitly, positives with onset, negatives stated where they downgrade. Then neurology by level (weakness pattern, reflexes, sensory level), pain behaviour, prior imaging baseline. Cauda-equina features trigger emergency language with bladder-scan results if available.
Paediatric and safeguarding letters
Developmental age framing (“at 2½ years, non-verbal with…”), consent and accompaniment noted, sedation needs anticipated, radiation justification stated briefly (clinical question outweighs dose — show the reasoning). Safeguarding: factual injury description with dating evidence, inconsistency between history and findings stated neutrally, designated-doctor notification status, no diagnostic conclusions beyond evidence. Neutral precision protects both child and writer.
Worked example: suspected stroke for urgent CT
Fictional case, newly written: Mr Ferreira, 68, sudden left-sided weakness and slurred speech 90 minutes ago; glucose 6.1; no seizure; on apixaban for AF; previous CT two years ago normal; GCS 14.
Shape: “Thank you for scanning Mr Ferreira, 68, urgently with suspected acute stroke, onset 90 minutes ago.” Timeline with glucose exclusion. Deficits and GCS. Anticoagulation status (treatment-defining). Request: “I would appreciate urgent non-contrast CT head with a view to reperfusion eligibility; onset time documented above.” Window explicit — roughly 165 words.
FAQs
Why does glucose always appear in stroke letters?
Hypoglycaemia mimics stroke and reverses with glucose — excluding it shows the referral is reasoned. One clause, always present.
Should sedation needs be anticipated?
Yes for paediatric and confused-adult referrals: state cooperation level and suggest the plan (play-specialist support? sedation assessment?). Anticipation speeds booking.
What is in the course?
Fourteen topic sections on neuroimaging, spine, paediatric and safeguarding letters with the five-paragraph skeleton, 47 lessons and 5 complete mock tests.
The matching course
OET Writing for Radiographers — Course 2 handles special cases properly: stroke windows, spine red flags, paediatric framing, safeguarding precision — 14 topic sections, 47 lessons, 5 mock tests. For letters where the rules change, train here.
Sources and note
- OET Writing format per the official OET site: oet.com — Writing. Windows and thresholds above are illustrative; follow local protocols in practice and current OET guidance for the exam.
- Course details verified from its public staging page (read-only): 14 topic sections, 47 lessons, 5 mock tests.
- Case and letter lines are newly written and fictional; other valid structures exist.
Put this into practice
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