• There is a poorly defined lesion within the anterior aspect of L4. It demonstrates iso-hyperintense signal on T1 compared to skeletal muscle, low T2 signal compared to marrow and is not visualised on stir sequences although there is some non specific oedema posterior to it. The lesion shows overt macroscopic signal drop out on the out of phase dixon sequences in keeping with focal nodular marrow hyperplasia. No further imaging follow-up for this is needed.