Medical image databases play an integral role in a digitized clinical environment starting from storing of electronic patient records, scanned medical images generated by Modalities like X-Ray and MR to reporting and billing. The operations in the clinical environment such as image storage and retrieval, viewing, and post processing can be served by a reusable database component using which different modalities can develop their own clinical applications. For a Multi-modality vendor, like Philips Medical Systems, it is profitable to have a platform group serving the diverse needs of these modalities through reusable components. This paper talks about the design considerations in realizing such a reusable medical database component.