1) Bring up SQL Server Management Studio.
2) Connect, and open the database you want to add the image to.
3) Expand the tables, and either add a new table with an appropriate index field, or right click teh table and select design.
4) Add a field called "myImage", and make its datatype "image". Allow nulls.
5) Close SQL Server Management studio.
To add images to the table (I will assume a new record, the table has an Identity field, and just teh myImage column):
using (SqlConnection con = new SqlConnection(connectionString))
using (SqlCommand com = new SqlCommand("INSERT INTO myTable (myImage) VALUES (@IM)", con))
byte imageData = File.ReadAllBytes(@"F:\Temp\Picture.jpg");