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Optimizing the radiologist-workstation interface: Resolving font legibility in PACS on high resolution monitors

Article number: [15600]

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Are the fonts in your PACS application tiny on your new high-resolution monitor? This is a common and frustrating issue, but we can explain why it happens and what you can do about it.


🤔 Why are the fonts so small?

It’s easy to assume that Display manufacturers have full control over how PACS applications—or other software—behave on high-resolution monitors. But this is not the case.

How Windows Applications Handle Display Scaling?

The way a Windows desktop application—like a PACS viewer—manages display scaling depends on how it's designed. Some applications are DPI-unaware, meaning they rely on Windows to automatically scale their interface. Others are DPI-aware, which means they handle scaling themselves for more accurate control over how content appears.

Monitors share details like resolution and DPI through something called EDID (Extended Display Identification Data). Windows and applications use this information to decide how things like font size, window layout, and scaling should be displayed. These settings can be adjusted at the system level or customized for individual users.

Some PACS viewers may need specific scaling settings to work properly or to display images clearly, so it’s important to check these when troubleshooting display font and visual issues.

So in essence this isn't a problem with your monitor; it's related to how the PACS application handles the huge number of pixels on a high-resolution display.

  • The Root Cause: This issue is recognized by all our PACS partners. It stems from limitations in how the third-party PACS software manages display scaling.

  • Our Limitation: We do not have the ability to change the font size or scaling behavior within the PACS application itself.

  • The Key: If your PACS system is set to use 100% scaling, all font adjustments must be made inside the application's code.

 


🚀 What can you do to fix it?

You have three main options. The best option depends on how your specific PACS application is configured:

1. Adjust Windows Display Scaling (quickest potential fix)

This is the fastest fix if your PACS application is NOT strictly limited to 100% scaling. This changes the size of all elements (text, icons, app windows) on your screen.

  1. Go to Start > Settings > System > Display.

  2. Under the "Scale and layout" section, look for the setting labeled "Change the size of text, apps, and other items."

  3. Click the dropdown menu and select a higher percentage (e.g., 125% or 150%).

  4. Action: Log out and log back in (or restart your PC) for the changes to fully take effect in all applications.


2. Contact your PACS Partner (Required if scaling is locked at 100%)

If adjusting Windows scaling doesn't work, it usually means your PACS system is strictly locked to 100% scaling. In this case, only the PACS developers can fix it.

  • Action: Reach out to your PACS vendor or support team.

  • Report: You are experiencing font rendering issues and scaling problems on a high-resolution (e.g., 32MP) monitor, and that the issue requires changes to the application's font scaling logic.


3. Try the Windows Text Size Workaround

If you are using only MDMC-32133 with no other displays, another option here may help by increasing the general size of text used across your Windows operating system. This only affects system-level text and may help some minor elements in the PACS application.

  1. Go to Start > Settings > Accessibility > Text size.

  2. Use the slider to increase the "Text size" (you’ll see a preview).

  3. Select Apply.

Curious about details of DPI Awareness? This helpful Microsoft Ignite article is a great starting point to learn more!  https://learn.microsoft.com/en-us/windows/win32/hidpi/high-dpi-desktop-application-development-on-windows

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Last updated Dec 9, 2025

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