VulnerabilityPublished 9 Apr 2026Updated 14 Apr 2026

CVE-2026-5444: Orthanc DICOM Server · Integer Overflow or Wraparound

Affects Orthanc DICOM ServerSource CVE Database V5

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Not known to be exploited · CVSS 7.1 High.

Data as of 29 Oct 2026, 19:04 UTC

CVSS 3.1 base score

7.1High

How severe the flaw is on the 0–10 CVSS scale.

EPSS: 0.1% chance of exploitation in 30 days – higher than 5% of CVEsExploit Prediction Scoring System: the likelihood attackers will use this flaw soon.

CVSS:3.1/AV:L/AC:L/PR:N/UI:R/S:U/C:N/I:H/A:H

Attack Vector: Local
Attack Complexity: Low
Privileges Required: None
User Interaction: Required
Scope: Unchanged
Confidentiality: None
Integrity: High
Availability: High

Bold values are the worst case: easiest to exploit or largest impact.

Attack Vector: Local: The vulnerable component is not bound to the network stack and the attacker’s path is via read/write/execute capabilities. Either: the attacker exploits the vulnerability by accessing the target system locally (e.g., keyboard, console), or remotely (e.g., SSH); or the attacker relies on User Interaction by another person to perform actions required to exploit the vulnerability (e.g., tricking a legitimate user into opening a malicious document).
Attack Complexity: Low: Specialized access conditions or extenuating circumstances do not exist. An attacker can expect repeatable success against the vulnerable component.
Privileges Required: None: The attacker is unauthorized prior to attack, and therefore does not require any access to settings or files to carry out an attack.
User Interaction: Required: Successful exploitation of this vulnerability requires a user to take some action before the vulnerability can be exploited.
Scope: Unchanged: An exploited vulnerability can only affect resources managed by the same security authority. In this case, the vulnerable component and the impacted component are either the same, or both are managed by the same security authority.
Confidentiality: None: There is no loss of confidentiality within the impacted component.
Integrity: High: There is a total loss of integrity, or a complete loss of protection. For example, the attacker is able to modify any/all files protected by the impacted component. Alternatively, only some files can be modified, but malicious modification would present a direct, serious consequence to the impacted component.
Availability: High: There is total loss of availability, resulting in the attacker being able to fully deny access to resources in the impacted component; this loss is either sustained (while the attacker continues to deliver the attack) or persistent (the condition persists even after the attack has completed). Alternatively, the attacker has the ability to deny some availability, but the loss of availability presents a direct, serious consequence to the impacted component (e.g., the attacker cannot disrupt existing connections, but can prevent new connections; the attacker can repeatedly exploit a vulnerability that, in each instance of a successful attack, leaks a only small amount of memory, but after repeated exploitation causes a service to become completely unavailable).

Definitions: FIRST CVSS v3.1 specification.

Exploitation evidence

Disclosed: evidence found.
CVE published 9 Apr 2026
Detectable: no evidence on record.
No public nuclei template indexed
Weaponized: no evidence on record.
No public exploit code indexed in Metasploit or Exploit-DB
Exploited in the wildExploited: no evidence on record.
Not in CISA KEV and no source reports exploitation
Observed by OffSeq MirageSeen by Mirage: no evidence on record.
No attack traffic recorded by OffSeq Mirage sensors

A missing step is not evidence of safety. Sources: cve.org (opens in a new tab), the Metasploit, Exploit-DB and nuclei-templates index as of 29 Oct 2026.

Disclosed: The CVE record is public on cve.org. Its publication is t = 0.
Detectable: A public nuclei template can find exposed instances, for defenders and attackers alike.
Weaponized: A Metasploit exploit module or Exploit-DB entry exists (Metasploit scanner modules do not count), or CISA SSVC or the CVSS exploit maturity reports a public proof of concept.
Exploited in the wild: CISA KEV lists it, CISA SSVC rates exploitation active, or a source reports attacks.
Observed by OffSeq Mirage: OffSeq Mirage honeypot sensors recorded attack traffic for this CVE, or found exposed hosts without attack traffic.

Moments are spaced evenly, not to scale; a dashed line marks a gap of six months or more. Deltas count from t = 0. Sources that give only a date (CISA KEV, Exploit-DB, or a time of exactly 00:00Z) read “same day” rather than hours. Metasploit modules carry the flaw’s disclosure date, not their release date, and nuclei templates carry no date, so both appear above but not on the timeline.

What to do

Affected software

Product	Affected	Fixed in
OrthancDICOM Server	Affected <=1.12.10	Fixed in–

AI-suggested

Until an official fix is available, avoid processing untrusted or specially crafted PAM images embedded in DICOM files. Monitor the vendor advisory for updates on patches or mitigations.

Description

A heap buffer overflow vulnerability exists in the PAM image parsing logic. When Orthanc processes a crafted PAM image embedded in a DICOM file, image dimensions are multiplied using 32-bit unsigned arithmetic. Specially chosen values can cause an integer overflow during buffer size calculation, resulting in the allocation of a small buffer followed by a much larger write operation during pixel processing.

Impact

Successful exploitation can lead to heap buffer overflow, potentially allowing an attacker to alter the integrity of the server or cause denial of service by crashing the application. Confidentiality is not impacted according to the CVSS vector. The attack requires local access and user interaction, limiting remote exploitation. No known exploits have been reported in the wild.

Summary

This vulnerability involves an integer overflow (CWE-190) in the Orthanc DICOM Server when parsing PAM images within DICOM files. Specifically, the image dimensions are multiplied using 32-bit unsigned arithmetic, which can overflow and cause the server to allocate a buffer smaller than required. Subsequent pixel processing writes beyond the allocated buffer, causing a heap buffer overflow. The CVSS v3.1 base score is 7.1, reflecting local attack vector, low attack complexity, no privileges required, user interaction needed, unchanged scope, no confidentiality impact, but high integrity and availability impacts.

CWE-190Integer Overflow or Wraparound (opens in a new tab)
Base weaknessLikelihood of exploit: Medium
The product performs a calculation that can produce an integer overflow or wraparound when the logic assumes that the resulting value will always be larger than the original value. This occurs when an integer value is incremented to a value that is too large to store in the associated representation. When this occurs, the value may become a very small or negative number.
Requirements
Ensure that all protocols are strictly defined, such that all out-of-bounds behavior can be identified simply, and require strict conformance to the protocol.
Requirements · Language Selection
Use a language that does not allow this weakness to occur or provides constructs that make this weakness easier to avoid.
Architecture and Design · Libraries or Frameworks
Use a vetted library or framework that does not allow this weakness to occur or provides constructs that make this weakness easier to avoid.
OWASP Cheat Sheets
XML Security (opens in a new tab)
Mass Assignment (opens in a new tab)
OWASP ASVS 4.0.3
V5.4.3 (opens in a new tab)
V13.3.1 (opens in a new tab)
V5.1.4 (opens in a new tab)
Attack patterns
Forced Integer Overflow (opens in a new tab)
From MITRE CWE, MITRE CAPEC and OWASP (Top 10, OpenCRE).

References

Community reviews

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Exploitation evidence

What to do

Affected software

Description

AI analysisMachine-generated, updated 17 Apr 2026, 11:41 UTC

WeaknessesCWE-190

Technical details

References

Community reviews

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