This paper presents the algorithms and results of the “idiap” team participation to the ImageCLEFmed annotation task in 2008. On the basis of our successful experience in 2007 we decided to integrate two different local structural and textural descriptors. Cues are com- bined through concatenation of feature vectors and through the Multi- Cue Kernel. The challenge this year was to annotate images coming mainly from classes with only few training examples. We tackled the problem on two fronts: (1) we introduced a further integration strategy using SVM as an opinion maker; (2) we enriched the poorly populated classes adding virtual examples. We submitted several runs considering different combinations of the proposed techniques. The run jointly using the feature concatenation, the confidence-based opinion fusion and the virtual examples ranked first among all submissions.