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I'm not 100 percent sure, but I believe that the "dark spots", often called hot spots, refer to abnormal amounts of radionuclide in the bone, determining that it is infected or diseased.

Though the previous person isn't completely wrong, it really depends on how the images are displayed. If there is a white background, anything dark = increase tracer uptake, which could be a multitude of things, from trauma (bruises), to fractures, to cancer. Other scans are performed to distinguish between the many possibilities. Basically the premise of a bone scan is to image the physiology of bones. The drug used for the scan is what your body uses to repair bones. Bones are constantly under repair due to old cells dying, and new cells taking their place so that is why the whole skeleton shows up. So, when there is an increase in the repair of bone, it wills how up brighter on the scan (if black background, it will be more white, and if white background, it will be more black). Hope that answers your question a tad better.

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