The current plan for suggesting depicts claims for structured data on Commons is to have a table with image key (probably sha1) + wikidata item ID, and then provide a review queue from which users can pick an image to review suggestions for.
This means that
- it should be possible to query images which have at least one unreviwed suggestion;
- presumably the list of those images would have to be sorted in some way (possibly in multiple ways) which makes sense to the user, such as most recently uploaded, most used/viewed, highest quality, my own uploads...
- there should be some mechanism to ensure we don't give the same image to many different users in parallel - by having a pop operation, or making the results sufficiently random.
Together these are nontrivial and probably not a great fit for a relational database. We should consider alternatives.