diff --git a/manage_breast_screening/mammograms/presenters/medical_information_presenter.py b/manage_breast_screening/mammograms/presenters/medical_information_presenter.py
index 85d4dde8a..29a7ee451 100644
--- a/manage_breast_screening/mammograms/presenters/medical_information_presenter.py
+++ b/manage_breast_screening/mammograms/presenters/medical_information_presenter.py
@@ -175,6 +175,14 @@ def read_only_symptom_rows(self):
             for symptom in self.symptoms
         ]
 
+    @property
+    def significant_symptom_rows(self):
+        return [
+            symptom.build_summary_list_row(include_actions=False)
+            for symptom in self.symptoms
+            if symptom.highlight_to_readers
+        ]
+
     @property
     def symptom_buttons(self):
         return [
diff --git a/manage_breast_screening/mammograms/presenters/symptom_presenter.py b/manage_breast_screening/mammograms/presenters/symptom_presenter.py
index 0db9e1d9a..ed4270d2f 100644
--- a/manage_breast_screening/mammograms/presenters/symptom_presenter.py
+++ b/manage_breast_screening/mammograms/presenters/symptom_presenter.py
@@ -19,6 +19,7 @@
 class SymptomPresenter:
     def __init__(self, symptom):
         self._symptom = symptom
+        self.highlight_to_readers = symptom.highlight_to_readers
 
     @property
     def area_line(self):
diff --git a/manage_breast_screening/mammograms/tests/presenters/test_medical_information_presenter.py b/manage_breast_screening/mammograms/tests/presenters/test_medical_information_presenter.py
index e0b2a12ed..e03c64eb9 100644
--- a/manage_breast_screening/mammograms/tests/presenters/test_medical_information_presenter.py
+++ b/manage_breast_screening/mammograms/tests/presenters/test_medical_information_presenter.py
@@ -31,9 +31,7 @@
 
 @pytest.mark.django_db
 class TestRecordMedicalInformationPresenter:
-    def test_formats_symptoms_summary_list(self):
-        appointment = AppointmentFactory.create()
-
+    def _create_default_symptoms(self, appointment):
         symptom1 = SymptomFactory.create(
             lump=True,
             appointment=appointment,
@@ -43,14 +41,12 @@ def test_formats_symptoms_summary_list(self):
             when_resolved="resolved date",
             additional_information="abc",
         )
-
         symptom2 = SymptomFactory.create(
             swelling_or_shape_change=True,
             appointment=appointment,
             when_started=RelativeDateChoices.LESS_THAN_THREE_MONTHS,
             area=SymptomAreas.BOTH_BREASTS,
         )
-
         symptom3 = SymptomFactory.create(
             other=True,
             appointment=appointment,
@@ -58,7 +54,6 @@ def test_formats_symptoms_summary_list(self):
             area=SymptomAreas.RIGHT_BREAST,
             symptom_sub_type_details="abc",
         )
-
         symptom4 = SymptomFactory.create(
             other=True,
             appointment=appointment,
@@ -67,6 +62,13 @@ def test_formats_symptoms_summary_list(self):
             highlight_to_readers=False,
             symptom_sub_type_details="xyz",
         )
+        return symptom1, symptom2, symptom3, symptom4
+
+    def test_symptom_rows(self):
+        appointment = AppointmentFactory.create()
+        symptom1, symptom2, symptom3, symptom4 = self._create_default_symptoms(
+            appointment
+        )
 
         presenter = MedicalInformationPresenter(appointment)
 
@@ -143,6 +145,78 @@ def test_formats_symptoms_summary_list(self):
             },
         ]
 
+    def test_read_only_symptom_rows(self):
+        appointment = AppointmentFactory.create()
+        self._create_default_symptoms(appointment)
+
+        presenter = MedicalInformationPresenter(appointment)
+
+        assert presenter.read_only_symptom_rows == [
+            {
+                "key": {
+                    "html": 'Lump<br><strong class="nhsuk-tag app-nowrap nhsuk-tag--yellow">Highlight to image readers</strong>',
+                },
+                "value": {
+                    "html": "Left breast<br>Not sure<br>Symptom is intermittent<br>Stopped: resolved date<br>Not investigated<br>Additional information: abc",
+                },
+            },
+            {
+                "key": {
+                    "html": 'Other<br><strong class="nhsuk-tag app-nowrap nhsuk-tag--yellow">Highlight to image readers</strong>'
+                },
+                "value": {
+                    "html": "Description: abc<br>Right breast<br>Less than 3 months ago<br>Not investigated"
+                },
+            },
+            {
+                "key": {"text": "Other"},
+                "value": {
+                    "html": "Description: xyz<br>Left breast<br>Less than 3 months ago<br>Not investigated"
+                },
+            },
+            {
+                "key": {
+                    "html": 'Swelling or shape change<br><strong class="nhsuk-tag app-nowrap nhsuk-tag--yellow">Highlight to image readers</strong>',
+                },
+                "value": {
+                    "html": "Both breasts<br>Less than 3 months ago<br>Not investigated",
+                },
+            },
+        ]
+
+    def test_significant_symptom_rows(self):
+        appointment = AppointmentFactory.create()
+        self._create_default_symptoms(appointment)
+
+        presenter = MedicalInformationPresenter(appointment)
+
+        assert presenter.significant_symptom_rows == [
+            {
+                "key": {
+                    "html": 'Lump<br><strong class="nhsuk-tag app-nowrap nhsuk-tag--yellow">Highlight to image readers</strong>',
+                },
+                "value": {
+                    "html": "Left breast<br>Not sure<br>Symptom is intermittent<br>Stopped: resolved date<br>Not investigated<br>Additional information: abc",
+                },
+            },
+            {
+                "key": {
+                    "html": 'Other<br><strong class="nhsuk-tag app-nowrap nhsuk-tag--yellow">Highlight to image readers</strong>'
+                },
+                "value": {
+                    "html": "Description: abc<br>Right breast<br>Less than 3 months ago<br>Not investigated"
+                },
+            },
+            {
+                "key": {
+                    "html": 'Swelling or shape change<br><strong class="nhsuk-tag app-nowrap nhsuk-tag--yellow">Highlight to image readers</strong>',
+                },
+                "value": {
+                    "html": "Both breasts<br>Less than 3 months ago<br>Not investigated",
+                },
+            },
+        ]
+
     def test_add_lump_button(self):
         appointment = AppointmentFactory()
 
diff --git a/manage_breast_screening/reading/jinja2/read_image.jinja b/manage_breast_screening/reading/jinja2/read_image.jinja
index e0d7aeba4..1b4eb004a 100644
--- a/manage_breast_screening/reading/jinja2/read_image.jinja
+++ b/manage_breast_screening/reading/jinja2/read_image.jinja
@@ -3,6 +3,7 @@
 {% from "nhsuk/components/inset-text/macro.jinja" import insetText %}
 {% from "nhsuk/components/summary-list/macro.jinja" import summaryList %}
 {% from "nhsuk/components/tag/macro.jinja" import tag %}
+{% from "nhsuk/components/warning-callout/macro.jinja" import warningCallout %}
 {% from "mammograms/check_information/medical_information_card.jinja" import medical_summary_card %}
 
 {# djlint:off H006 #}
@@ -56,6 +57,15 @@
       </div>
     </div>
 
+    {% if medical_information_presenter.significant_symptom_rows %}
+      {{ warningCallout({
+        "heading": "Significant symptoms reported",
+        "html": summaryList({
+          "rows": medical_information_presenter.significant_symptom_rows
+        }),
+      }) }}
+    {% endif %}
+
     <div class="nhsuk-grid-row">
       <div class="nhsuk-grid-column-one-third nhsuk-u-margin-bottom-4">
         <h2 class="nhsuk-heading-s">Image thumbnails ({{ images | length }})</h2>
@@ -112,7 +122,7 @@
       }) }}
     {% endif %}
 
-    {{ medical_summary_card(presented_medical_information) }}
+    {{ medical_summary_card(check_medical_information_presenter) }}
   </div>
 </div>
 {% endblock %}
diff --git a/manage_breast_screening/reading/views.py b/manage_breast_screening/reading/views.py
index 682a1cad7..530d6455f 100644
--- a/manage_breast_screening/reading/views.py
+++ b/manage_breast_screening/reading/views.py
@@ -10,6 +10,9 @@
 from manage_breast_screening.mammograms.presenters.medical_history.check_medical_information_presenter import (
     CheckMedicalInformationPresenter,
 )
+from manage_breast_screening.mammograms.presenters.medical_information_presenter import (
+    MedicalInformationPresenter,
+)
 from manage_breast_screening.participants.models import Appointment
 
 logger = getLogger(__name__)
@@ -39,7 +42,10 @@ def get_context_data(self, **kwargs):
                 "heading": participant.full_name,
                 "caption": "Review images",
                 "images": images,
-                "presented_medical_information": CheckMedicalInformationPresenter(
+                "check_medical_information_presenter": CheckMedicalInformationPresenter(
+                    appointment
+                ),
+                "medical_information_presenter": MedicalInformationPresenter(
                     appointment
                 ),
                 "notes_for_reader": appointment.study.additional_details,