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In this paper we show how grid computing can be used to improve the operation of a medical image search system. The paper introduces the basic principles of a content-based image retrieval (CBIR) system and identifies the computationally challenging tasks in the system. For the computationally challenging tasks an efficient design is proposed that uses distributed grid computing to carry out the image processing in a distributed and efficient way. The algorithms of the search system are executed by using a real medical image collection as input and a grid computing infrastructure to provide the needed computing power. Finally, the results show how the image processing task that required tens of hours to complete can be processed by using only a fraction of the originally required computing time.