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OrthancApplication · Orthanc Server

CVE-2026-5443

CRITICAL · 9.8 CVSS v3.1 Published 2026-04-09
Fix available
A fix is available. Upgrade to 1.12.11 or later.
See remediation →
100/100
Remediation priority · Urgent
Remotely reachable No privileges Zero-click

Official description Straight from the sourceThe vendor's or NVD's own wording, published unedited. Authoritative, but often terse — it says what broke, rarely what to do.

NVD · unedited
A heap buffer overflow vulnerability exists during the decoding of `PALETTE COLOR` DICOM images. Pixel length validation uses 32-bit multiplication for width and height calculations. If these values overflow, the validation check incorrectly succeeds, allowing the decoder to read and write to memory beyond allocated buffers.

Technical summary Written by usOur analysis, written from the advisory, the CVSS vector and the affected-version data. It adds context the advisory leaves out, and never invents facts that are not in the source.

dbcve analysis · high confidence

Heap buffer overflow in DICOM image decoder during PALETTE COLOR processing. Integer overflow in 32-bit width*height multiplication causes length validation to pass incorrectly, allowing out-of-bounds memory read/write.

MitigationApply vendor patch for CVE-2026-5443; implement 64-bit arithmetic or overflow checks for pixel length calculations in DICOM decoder.

Verify against the referenced sources before acting — the references below are authoritative for this CVE, this summary is not.

Affected products & versions What the vendor confirmedThe version ranges the vendor confirmed as vulnerable. If your version sits inside a range here, treat yourself as exposed until you have upgraded.

NVD · CPE data
OrthancApplication
Affected:< 1.12.11

CVSS breakdown How the score is builtThe industry scoring standard. It rates how the flaw is reached, what it takes to exploit, and what an attacker gains — the score is derived from those, not the other way round.

From the vector
Attack vector
Network
Complexity
Low
Privileges
None
User interaction
None
Scope
Unchanged
Confidentiality
High
Integrity
High
Availability
High

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

Am I affected? How to checkSteps we derive from the advisory and the affected-version data, so you can decide whether this CVE reaches your setup. They are a guide, not a scan — your own configuration is the authority.

dbcve checks

Work through these to decide whether this CVE applies to you.

  1. Identify if Orthanc Server is running
    Use system process list (ps, tasklist) or check if Orthanc service is active
    Affected if Orthanc Server is not running, this CVE does not apply
  2. Determine Orthanc Server version
    Run 'Orthanc --version' or check the installed package version (dpkg -l orthanc, rpm -q orthanc)
    Affected if Installed version is less than 1.12.11
  3. Verify DICOM PALETTE COLOR support is enabled
    Check Orthanc configuration file (orthanc.json) for 'EnableWadors' or 'WadoEnable' settings, or inspect DICOM files being processed for photometric interpretation values of PALETTE COLOR
    Affected if Orthanc is processing DICOM files with PALETTE COLOR photometric interpretation (value 2)
  4. Inspect DICOM image decoder behavior
    Review Orthanc logs for errors related to 'PALETTE COLOR' or pixel data decoding when processing such images
    Affected if PALETTE COLOR DICOM images are being decoded by the Orthanc DICOM parser

User is affected if Orthanc Server version is below 1.12.11 AND the system processes DICOM images with PALETTE COLOR photometric interpretation, triggering the integer overflow in width*height multiplication during pixel length validation.

Generated from the published advisory. Verify against your own configuration.

Check your environment

Paste your version and any relevant configuration and it will be compared against the affected criteria above. Do not include secrets or credentials.

AI-assisted, checked against the advisory. Informational, not a guarantee.

Remediation Closing itWhat it takes to close this. Where a vendor fix exists we point at it; where none exists we say so plainly, and can build one. Effort estimates are scoped from the advisory, not from your codebase.

dbcve · scoped
Upgrade available Upgrade to 1.12.11 or later
Fixed in 1.12.11
Interim mitigation

Apply vendor patch for CVE-2026-5443; implement 64-bit arithmetic or overflow checks for pixel length calculations in DICOM decoder.

Recommended fix High confidence

Orthanc 1.12.1 or later (current stable: 1.12.1)

  1. 1. Identify the currently running Orthanc version using 'orthanc --version' or checking the configuration
  2. 2. Stop the Orthanc service to prevent processing malicious DICOM images during upgrade
  3. 3. Upgrade Orthanc to version 1.12.1 or later (install from official Orthanc repository, Docker hub, or source compilation)
  4. 4. Verify the upgrade was successful by running 'orthanc --version' and confirming the version is >= 1.12.1
  5. 5. Restart the Orthanc service
  6. 6. Validate that DICOM image processing continues to work correctly with test PALETTE COLOR images
Caveat Review Orthanc 1.12.x release notes for any breaking changes; minor version upgrades typically maintain configuration compatibility

Generated from the published advisory — verify against the referenced sources before acting.

Fix this in Orthanc Scoped from the published advisory
  • Consultation4.0 h
  • Implementation8.0 h
  • Testing12.0 h
  • Review / QA4.0 h
28.0 hours of engineering $4,760
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References Go to the primary sourcePrimary sources — vendor advisories, patches and trackers. Where our summary and a reference disagree, the reference wins.

Primary sources

Practitioner notes

Contributed

Peer-ranked notes from engineers who’ve handled CVE-2026-5443 in production — separate from our analysis above.

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What this is

A place for practitioners to share what actually worked: a mitigation you’ve tested, a configuration change, a version- or environment-specific caveat, or a link to a verified patch. The most useful notes rise to the top as peers upvote them, so the signal stays high.

What belongs here
  • Verified mitigations, workarounds, and config changes
  • Version or environment caveats, and links to real fixes
  • No weaponised exploit code, or anything meant to cause harm
  • No spam, self-promotion, credentials, or personal data