OET Case Notes: Radiography — Chest CT Findings Report (Intermediate)
A radiographer reports CT chest findings to a referring respiratory consultant for a 62-year-old ex-smoker with an incidental 12 mm solitary pulmonary nodule. The intermediate challenge: translating technical imaging findings into concise clinical language, selecting what matters for the consultant's decision, and framing a recommendation without exceeding the radiographer's clinical scope.
Letter type
Referral
Write to
Referring Consultant (Respiratory Physician)
Target length
200–230 words
The case notes
Patient: Mr David Morrison, 62 years old
Reason for CT: Incidental 12 mm pulmonary nodule on chest X-ray during pre-operative assessment
Scan performed: CT thorax with contrast (2 mm slice thickness)
Right upper lobe: 12 × 10 mm soft tissue nodule, well-defined margins, non-calcified, no satellite nodules; Fleischner category CT-2
Hilar/mediastinal nodes: No pathological lymphadenopathy
Lung parenchyma: Background centrilobular emphysema bilaterally, consistent with smoking history; no consolidation, pleural effusion, or pneumothorax
Clinical history: Ex-smoker (30 pack-years, quit 8 years ago); no haemoptysis, weight loss, or systemic symptoms
Impression: Indeterminate 12 mm RUL nodule; malignancy cannot be excluded; surveillance recommended
Writing task
Write a report letter to referring consultant Dr Claire Nguyen summarising the CT chest findings, your impression, and your recommendation for follow-up.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
-
The nodule's size, location, and key characteristics (margins, calcification)
These are the decision-relevant imaging features. The consultant needs them to classify risk and plan follow-up. Size without location or margin detail is incomplete.
-
The Fleischner category and recommended follow-up interval
Using the Fleischner classification frames the recommendation within an evidence-based guideline, which is expected in a radiography report letter.
-
The background emphysema with reference to the smoking history
Incidental findings relevant to the clinical background must be included. Emphysema in a 30-pack-year ex-smoker is clinically significant and contextualises nodule risk.
Leave out
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Technical imaging parameters beyond slice thickness (kV, mA, dose report)
These belong in the technical record, not the clinical letter. The consultant needs findings and recommendations, not radiation physics.
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Listing all normal structures
Mention normal structures only if the clinical question required their exclusion. Listing everything normal pads the letter without adding clinical value.
Criterion in focus · Conciseness & Clarity
Radiology report letters are among the most concise in clinical correspondence. The examiner penalises redundancy: '12 × 10 mm well-defined non-calcified nodule' carries the same information as a much longer description in 40% of the words. Every adjective must earn its place. If removing it would not change the consultant's decision, cut it.
Now write the letter — and find out what is blocking your Grade B
Write a 200–230 words referral letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.