In my N=1 experience, pain correlates with BMLs more than cartilage loss. I presented with pain, no cartilage, and BMLs. After treatment the BMLs were gone and so was the pain, despite no new cartilage. I find that interesting.
I think saying BMLs are the bone filling with fluid is focussing on the background. The interesting stuff is what’s happening in the foreground - the bone is breaking down and dissolving. Fluid just fills the space the bone used to be. It’s mechanically weaker, so subject to more breakdown, and on it goes.
MRIs measure water mobility. In open spaces where water molecules are free to move they have high mobility. In tight pores where they can’t move easily the signal is low. Those bright spots in the MRIs map out regions of high water mobility, which is to say loss of bone. So when they disappear it means the bone has regrown and recovered it’s density, and strength.
I’m a bit over halfway through my third PPS treatment. I’ll get MRIs after, looking forward to seeing how they turn out. I’m feeling great.
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