AWS Integration Question

Hey everyone,

I’m new to DICOM and Orthanc. I’m currently replacing PostDicom with Orthanc and I’m doing so on AWS. I found this single click cloudformation here that was very helpful for setting things up as far as the reverse proxy goes. I’m a bit confused though and I’ve read almost all of the Orthanc documentation but haven’t figured this out. How can I connect an AE Client to this setup? I have a reverse proxy which leads me to the Orthanc frontend but I need to connect a medical device with IP and port. I’ve got the IP of the EC2 instance and when I run nmap on that it shows port 4242 is closed. The docker instances running doesn’t show any ports mapped. I’m using pynetdicom as a “virtual” AE Client. I spun up a local Orthanc in docker and connected to it just fine with localhost so I know that the virtual client works. Could anyone provide resources that might help me out here? I’m learning a lot as I go so anything helps, really. Thanks!


To me, this looks more like a question about AWS infrastructure, most probably related to the fact that the 4242 port is blocked by the EC2 firefall (4242 corresponds to the default TCP port for the DICOM protocol in Orthanc). Get in touch with the AWS support (you pay them to this end).

That being said, it is not recommended to use the DICOM protocol over Internet. You should use a solution like a VPN, stunnel or a SSH tunnel to map the 4242 port of your cloud instance onto your local network:


Thanks so much for the reply! I was able to connect to 4242 through the IP of the load balancer for the cloud formation stack. For the CF stack, I used this template. For context, I’m attempting to replace postDICOM with Orthanc on AWS. I know that postDICOM gives a user a local IP (like a 192 address) for the medical device to use and typically you’ll connect that to a laptop that has internet access and has a postDICOM public IP (internet facing). I’m not sure how postDICOM accomplishes this, whether it be an SSH tunnel or VPN. I know this template has a reverse proxy built-in but I’m still digging into how it’s meant to be used. The article which presents the template is more about SageMaker than Orthanc itself.

This template also uses your Orthanc docker image so, thank you for that!