We present the status of ongoing work toward the development of a biomedical information system at the Lister Hill National Center for Biomedical Communications, a research and development division of the National Library of Medicine (NLM). For any class of biomedical images, the problems confronting the researcher in image indexing are (a) developing robust algorithms for localizing and identifying anatomy relevant for that image class and relevant to the indexing goals, (b) developing algorithms for labeling the segmented anatomy based on its pathology, (c) developing a suitable indexing and similarity matching method for visual data, and (d) associating the text information on the imaged person, indexed separately, for query and retrieval along with the visual information. We are in the process of building a content-based image retrieval system which supports hybrid image and text queries and includes a biomedical image database. The paper describes this prototype CBIR2 system and the algorithms used in it. Image shape based retrieval is done by image example and user sketch of the vertebrae on the spine x-ray images from the National Health and Nutrition Examination Survey (NHANES) data.