Spectrum of imaging findings on axial T2-weighted fat-saturated imaging of the lumbar spine

•Axial T2FS images show pathology not readily seen with routine sequences.•Axial T2FS shows hyperaemic and inflammatory changes, increasing diagnostic utility.•Diagnostic accuracy can be increased without increasing examination time.

Axial T2-weighted fat-saturated imaging provides information not readily available from routine lumbar spine magnetic resonance imaging (MRI) protocols and routine inclusion of this sequence in place of axial T1-weighted imaging provides additional diagnostic information that can be obtained without increasing examination time or cost. The purpose of this review is to highlight the value of axial T2-weighted fat-saturated imaging as part of a routine lumbar spine MRI protocol.