Certain examples provide systems and methods for medical diagnostic collaboration. An example system includes a conversation manager to facilitate a first conversation between a first device and a second device. The conversation manager manages a plurality of conversations based on respective conversation identifiers assigned to each of the plurality of conversations. The example system also includes a collaboration session manager to facilitate, via the first conversation, a collaboration session between the first and second devices, which allows a user of the first device and a user of the second device to view, share, and comment on a medical study. In addition, the example system includes a context manager to manage context information to describe a state of the medical study as it is displayed on the first device to synchronize a state of the medical study displayed on each of the first and second devices.