CVE-2024-33606: MicroDicom Viewer Information Disclosure

CVE-2024-33606 Overview

CVE-2024-33606 is a vulnerability affecting MicroDicom DICOM Viewer that allows an attacker to retrieve sensitive files (medical images) as well as plant new medical images or overwrite existing medical images on affected systems. This vulnerability combines missing authorization (CWE-862) with improper URL handling (CWE-939), creating a significant risk to the integrity and confidentiality of medical imaging data.

Critical Impact

Attackers can access, modify, or overwrite sensitive medical images, potentially compromising patient care and data integrity in healthcare environments. User interaction is required to exploit this vulnerability.

Affected Products

• MicroDicom DICOM Viewer (all versions prior to patched release)
• Healthcare systems utilizing MicroDicom DICOM Viewer for medical imaging
• Network-accessible DICOM Viewer installations

Discovery Timeline

• 2024-06-11 - CVE-2024-33606 published to NVD
• 2025-04-23 - Last updated in NVD database

Technical Details for CVE-2024-33606

Vulnerability Analysis

This vulnerability stems from two fundamental security weaknesses in MicroDicom DICOM Viewer: missing authorization controls (CWE-862) and improper handling of URL parameters (CWE-939). The combination of these flaws enables unauthorized access to sensitive medical imaging data through network-based attack vectors.

The vulnerability allows attackers to perform unauthorized operations on medical image files stored within the DICOM Viewer system. Without proper authorization checks, the application fails to validate whether incoming requests have legitimate access rights to view, create, or modify medical images. Additionally, improper URL handling enables attackers to craft malicious requests that can traverse directories or manipulate file paths to access restricted resources.

Medical imaging systems are particularly sensitive targets due to the nature of the data they contain, including protected health information (PHI) subject to regulatory requirements such as HIPAA. Successful exploitation could lead to unauthorized disclosure of patient medical images, manipulation of diagnostic data, or destruction of critical healthcare records.

Root Cause

The root cause of CVE-2024-33606 lies in insufficient access control mechanisms combined with improper URL validation in the MicroDicom DICOM Viewer application. The software fails to properly verify that users are authorized to perform requested operations on medical image files, and does not adequately sanitize URL parameters that could be used to access files outside intended directories. This lack of defense-in-depth allows authenticated or unauthenticated attackers to bypass intended security restrictions.

Attack Vector

The attack vector for this vulnerability is network-based, requiring user interaction to succeed. An attacker could craft malicious requests targeting the DICOM Viewer system over the network. The attack scenario typically involves:

1. Identifying a vulnerable MicroDicom DICOM Viewer instance accessible over the network
2. Crafting malicious requests designed to bypass authorization controls
3. Leveraging improper URL handling to access, upload, or overwrite medical image files
4. Tricking a user into interacting with the malicious content or link

The vulnerability leverages weaknesses in how the application handles authentication and file access operations. Sensitive medical images could be exfiltrated, or malicious images could be planted in the system, potentially affecting diagnostic accuracy and patient care decisions.

Detection Methods for CVE-2024-33606

Indicators of Compromise

• Unexpected access patterns to DICOM image files from unusual source IP addresses
• Unauthorized creation or modification of medical image files outside normal workflow
• Anomalous HTTP requests targeting DICOM Viewer endpoints with unusual URL parameters
• Log entries showing access attempts to files outside designated DICOM storage directories

Detection Strategies

• Monitor network traffic for suspicious requests targeting MicroDicom DICOM Viewer services
• Implement file integrity monitoring on DICOM image storage directories to detect unauthorized changes
• Deploy web application firewall rules to detect and block path traversal attempts
• Configure SIEM rules to alert on access patterns inconsistent with normal clinical workflows

Monitoring Recommendations

• Enable detailed logging on MicroDicom DICOM Viewer and forward logs to centralized SIEM
• Monitor for unusual file system operations in medical image storage locations
• Track authentication events and failed access attempts to DICOM resources
• Implement baseline analysis of normal DICOM Viewer usage patterns to identify anomalies

How to Mitigate CVE-2024-33606

Immediate Actions Required

• Review the CISA Medical Advisory ICSMA-24-163-01 for detailed remediation guidance
• Isolate vulnerable MicroDicom DICOM Viewer systems from untrusted networks where possible
• Implement network segmentation to restrict access to DICOM systems to authorized clinical workstations only
• Audit current DICOM image files for signs of unauthorized access or modification

Patch Information

Organizations should consult the official MicroDicom vendor channels and the CISA Medical Advisory ICSMA-24-163-01 for specific patch availability and installation instructions. Healthcare organizations should prioritize patching medical imaging systems due to the sensitive nature of the data involved and potential regulatory compliance implications.

Workarounds

• Restrict network access to MicroDicom DICOM Viewer systems using firewall rules to allow only authorized IP addresses
• Implement additional authentication layers such as VPN requirements for remote access to medical imaging systems
• Enable strict access control lists on DICOM image storage directories at the operating system level
• Deploy application-layer filtering to block requests containing suspicious URL patterns or path traversal sequences

# Network segmentation example - restrict DICOM Viewer access
# Add firewall rules to limit access to authorized clinical workstations only
iptables -A INPUT -p tcp --dport 104 -s 10.0.10.0/24 -j ACCEPT
iptables -A INPUT -p tcp --dport 104 -j DROP

# Enable file integrity monitoring on DICOM storage
# Example using AIDE (Advanced Intrusion Detection Environment)
echo "/dicom/storage CONTENT" >> /etc/aide.conf
aide --init