sync two different Orthanc servers with the same storage folder

I have installed Orthanc on two different computers, setting the
storage folder on the cloud folder on each; so, importind dicoms into one
othanc duplicate the exact orthanc storage folder on the other pc.
The database is perfectly replicated, but no patients can be seen on
the second pc. What am I doing wrong?
Thank you.

Hi, rrzvnx!

Please, check your index settings. It is through the index that Orthanc knows about each image it has stored.

You might want to try a database plugin to host the index (eg: PostgreSQL or MySQL). If one of them is read-only, you SHOULD have no problem.

If both must accept new images, though, you’ll might run into concurrency problems because internally Orthanc uses semaphores to deal with concurrency and that must be dealt with when considering different processes.


When you mention “setting the storage folder on the cloud folder on each”; you mean they’re in your “DropBox” folder or equivalent ?

This is really not the recommended way to synchronize Orthancs.

The Dicom file will indeed synchronize correctly but not the index (

For a proper way of synchronizing 2 orthancs, check