I agree with Kevin. I can not think of any cms that are not stored in the file system. then the only problem that arises with this method is that you plan to cluster multiple web servers to run your cms. if so, then you need to plan it and be able to point all web servers to the same file storage location.
used for many years, the isive method downloads, resizes the image to something practical for the Internet, then generates a thumbnail, then writes them to the file system and writes a pointer to the database.
if the site is a huge site, then you need to serve images from cache servers, because file systems are very slow compared to network IO. for example, on Facebook, they have billions of images on their site, and finally I heard that 80% were stored in cache servers around the world in ram. the file storage array that they have is more or less backed up to cache servers.
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