CVE-2025-24485: Meddream PACS Server SSRF Vulnerability

CVE-2025-24485 Overview

A server-side request forgery (SSRF) vulnerability exists in the cecho.php functionality of MedDream PACS Premium 7.3.5.860. This vulnerability allows an unauthenticated attacker to send specially crafted HTTP requests that can force the server to make arbitrary requests to internal or external resources. MedDream PACS is a medical imaging viewer and Picture Archiving and Communication System (PACS) used extensively in healthcare environments, making this vulnerability particularly concerning for organizations handling sensitive patient data.

Critical Impact

Unauthenticated attackers can exploit this SSRF vulnerability to access internal network resources, potentially exposing sensitive healthcare data, internal services, and cloud metadata endpoints without any authentication requirements.

Affected Products

• MedDream PACS Server Premium 7.3.5.860
• MedDream PACS Premium (potentially other versions)

Discovery Timeline

• 2025-07-28 - CVE-2025-24485 published to NVD
• 2025-11-03 - Last updated in NVD database

Technical Details for CVE-2025-24485

Vulnerability Analysis

This SSRF vulnerability resides in the cecho.php endpoint of MedDream PACS Premium. The vulnerable functionality fails to properly validate or sanitize user-supplied URLs or destination parameters before the server processes outbound requests. As a result, attackers can manipulate the server into sending HTTP requests to arbitrary destinations, including internal network resources that would otherwise be inaccessible from external networks.

The vulnerability is classified under CWE-918 (Server-Side Request Forgery), which describes weaknesses where an application fetches remote resources based on user-supplied input without sufficient validation. In healthcare environments running MedDream PACS, this could allow attackers to probe internal network infrastructure, access cloud provider metadata services, or interact with other internal services that trust requests originating from the PACS server.

Root Cause

The root cause of this vulnerability is insufficient input validation in the cecho.php functionality. The application accepts user-controlled input that influences the destination of server-initiated HTTP requests without implementing proper URL validation, allowlist controls, or destination filtering. This allows attackers to redirect these requests to arbitrary endpoints, bypassing network segmentation and access controls.

Attack Vector

The attack is network-based and requires no authentication, making it highly accessible to remote attackers. An attacker can craft malicious HTTP requests to the cecho.php endpoint, specifying internal IP addresses, cloud metadata endpoints (such as 169.254.169.254 for AWS/Azure/GCP), or other sensitive internal resources as the target destination.

The SSRF vulnerability can be exploited to:

• Scan internal network infrastructure and services
• Access cloud provider metadata endpoints to retrieve credentials
• Interact with internal APIs or administrative interfaces
• Exfiltrate sensitive data through the server's network position
• Bypass firewall rules by leveraging the server's trusted network position

For detailed technical information about this vulnerability, refer to the Talos Intelligence Vulnerability Report.

Detection Methods for CVE-2025-24485

Indicators of Compromise

• Unusual outbound HTTP requests originating from the MedDream PACS server to internal IP ranges or cloud metadata endpoints
• HTTP requests to cecho.php with suspicious URL parameters containing internal IP addresses or localhost
• Network traffic from the PACS server to unusual destinations such as 169.254.169.254 or internal service ports
• Access logs showing requests to cecho.php from external IP addresses with encoded or obfuscated URL parameters

Detection Strategies

• Monitor HTTP access logs for requests to cecho.php containing URL parameters that reference internal IP addresses (10.x.x.x, 172.16.x.x, 192.168.x.x), localhost, or cloud metadata IPs
• Implement network-level monitoring to detect outbound connections from the MedDream PACS server to internal resources that are not part of normal PACS operations
• Deploy web application firewall (WAF) rules to detect and block SSRF patterns in requests to the cecho.php endpoint
• Utilize SentinelOne's network visibility features to identify anomalous server-side request patterns

Monitoring Recommendations

• Enable detailed access logging for the MedDream PACS web application with particular attention to the cecho.php endpoint
• Configure network monitoring to alert on outbound connections from the PACS server to cloud metadata endpoints or internal service ports
• Implement egress filtering and monitoring to detect unexpected outbound traffic from healthcare imaging systems
• Review DNS query logs from the PACS server for unusual resolution requests that may indicate SSRF exploitation attempts

How to Mitigate CVE-2025-24485

Immediate Actions Required

• Restrict network access to the MedDream PACS server from untrusted networks using firewall rules
• Implement a web application firewall (WAF) with SSRF-specific rules to filter malicious requests to cecho.php
• Configure egress filtering on the PACS server to limit outbound connections to only required destinations
• Block access to cloud metadata endpoints (169.254.169.254) from the PACS server if running in cloud environments
• Review access logs for evidence of exploitation attempts and investigate any suspicious activity

Patch Information

Check with MedDream for available security patches addressing this vulnerability. Monitor the Talos Intelligence Vulnerability Report for updates on remediation guidance and patch availability. Until a patch is available, implement the workarounds and network-level controls described below.

Workarounds

• Implement strict network segmentation to isolate the MedDream PACS server from sensitive internal resources
• Configure the PACS server's firewall to block outbound connections to internal network ranges and cloud metadata endpoints
• Deploy a reverse proxy or WAF in front of the PACS server to validate and sanitize incoming requests to cecho.php
• If the cecho.php functionality is not required, consider disabling or restricting access to this endpoint
• Implement IP allowlisting to restrict which clients can access the MedDream PACS web interface

# Example iptables rules to block SSRF to internal networks and cloud metadata
# Apply these rules on the MedDream PACS server

# Block access to cloud metadata endpoint
iptables -A OUTPUT -d 169.254.169.254 -j DROP

# Block access to common internal network ranges (adjust as needed)
iptables -A OUTPUT -d 10.0.0.0/8 -p tcp --dport 80 -j DROP
iptables -A OUTPUT -d 172.16.0.0/12 -p tcp --dport 80 -j DROP
iptables -A OUTPUT -d 192.168.0.0/16 -p tcp --dport 80 -j DROP

# Allow only necessary outbound connections for PACS functionality
# (Configure specific allow rules based on your environment before applying these blocks)