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This paper considers some of the design issues associated with building a medical thermographic expert system. Medical thermography records the temperature distribution of the human body, which is related to physiological and pathological changes. Interpreting thermal images is difficult even for expert thermographers and often relies on subjective criteria. Quantification of the assessment of thermal images has been put forward as a solution to improve the interpretation. We present a general framework for the design of an expert system that would greatly facilitate the processing of thermal images and assist the thermographer in identifying abnormal temperature distribution.