We investigate formal semantics, as well as corpus linguistics and context based rules for ontology alignment in the medical domain. Semantic image retrieval should provide the basis for help in clinical decision support and computer aided diagnosis. Medical image and data retrieval for anatomy, diseases, or other patient-centric information require a comprehensive mapping of medical ontologies. We enhanced previous approaches of ontology matching for supporting collaboration by incorporating domain-specific context information of the application domain. The evaluation shows that axiomatic models in combination with syntactic rules and context information are very effective in terms of precision, recall, and F1 measure.