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Pacsgear Pacs Scan CVE-2026-58126

| EUVDEUVD-2026-41036 CRITICAL
Missing Authentication for Critical Function (CWE-306)
2026-07-01 VulnCheck GHSA-v3r5-hc9j-49g7
9.3
CVSS 4.0 · Vendor: VulnCheck
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Vulnerability Assessment

Weakness
CWE
OWASP Top 10:2025
A07:2025 - Authentication Failures
ASVS 5.0
V6 - Authentication Authentication required for critical functions
MITRE ATT&CK

1 technique across 1 tactic: Initial Access

The technique list with ATT&CK links and the kill-chain view is part of the Basic plan and up.

Act Now Prioritize within 24-48h. Why: CRITICAL severity + public POC available.
No patch listed yet 0.8% exploitation probability (EPSS)

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AnalysisAIv1 – Jul 01, 2026

Unauthenticated remote code execution in Hyland PACSgear PACS Scan 5.2.1 lets remote attackers gain SYSTEM-level control of medical imaging servers by abusing an exposed .NET Remoting TCP service (PGImageExchQueue.exe) on port 22222. The exposed service grants arbitrary file read/write with no authentication, which is chained with a DLL hijack in the PGImageExchangeQueueSvc.exe service to run code as NT AUTHORITY\SYSTEM. Publicly available exploit code exists (published by VulnCheck); there is no public exploit identified as actively exploited, as it is not listed in CISA KEV.

Affected VersionsENISA

PACSgear PACS Scan 5.2.1

Affected Packages

euvd pacsgear_pacs_scan no fix

Source: OSV (Open Source Vulnerabilities)

Affects your stack

Affects 1 package in euvd

Checking this CVE against your own stacks and servers is part of the Basic plan and up.

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  • Exploit and PoC references, threat intelligence from 22 sources

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Severity by source

Vendor (VulnCheck) PRIMARY 9.3 CRITICAL
CVSS:4.0/AV:N/AC:L/AT:N/PR:N/UI:N/VC:H/VI:H/VA:H/SC:N/SI:N/SA:N

Primary rating from Vendor (VulnCheck) · only source for this CVE.

CVSS VectorVendor: VulnCheck

Attack Vector
Network
Attack Complexity
Low
Attack Requirements
None
Privileges Required
None
User Interaction
None
Vulnerable system: Confidentiality
High
Vulnerable system: Integrity
High
Vulnerable system: Availability
High
Subsequent system: Confidentiality
None
Subsequent system: Integrity
None
Subsequent system: Availability
None

DescriptionCVE.org

PACSgear PACS Scan 5.2.1 contains an unauthenticated remote code execution vulnerability that allows remote attackers to read and write arbitrary files by exploiting an exposed .NET Remoting TCP service on port 22222 via PGImageExchQueue.exe without any authentication requirement. Attackers can chain the arbitrary file write primitive with DLL hijacking in PGImageExchangeQueueSvc.exe, which loads missing DLLs such as CRYPTSP.DLL from the application directory, to achieve remote code execution as NT Authority\SYSTEM upon service restart.

Executive ViewAI

Why It Matters

Hyland PACSgear PACS Scan 5.2.1 contains an unauthenticated remote code execution vulnerability enabling attackers to obtain SYSTEM-level access to medical imaging servers without authentication. With no patch available, unpatched systems face immediate risk of compromise affecting patient data confidentiality, imaging integrity, and continuity of clinical care operations.

Recommended Action

24 hours: Identify all Hyland PACSgear PACS Scan 5.2.1 installations; restrict network access to port 22222 (PGImageExchQueue.exe service) via firewall rules; document business-critical PACS dependencies. 7 days: Implement network segmentation isolating PACS infrastructure; enable enhanced logging for port 22222 connections and service directory file modifications; scan for indicators of compromise (unauthorized DLLs, modified service binaries). 30 days: Upgrade to patched Hyland PACSgear PACS Scan version once released by vendor; verify integrity of all medical imaging data post-upgrade; conduct tabletop exercise for incident response to PACS compromise.

Business Impact: Severe
Compensating Controls

No vendor-released patch identified at time of analysis. Interim mitigations: (1) Restrict inbound access to port 22222 at network perimeter and internal firewalls; (2) Disable PGImageExchQueue.exe TCP service if clinical operations permit; (3) Deploy application whitelisting to prevent DLL injection into PGImageExchangeQueueSvc.exe directory; (4) Monitor for anomalous .NET Remoting connections and DLL modifications; (5) Maintain offline backups of critical imaging databases; (6) Implement file integrity monitoring on service executable and DLL directories with daily verification.

Threat Intelligence Overview

EPSS Score
0.8%
Top 50% exploitable
Exploit
POC
Public exploit code exists
Social Media
1
Sightings
Data Quality
6 sources
Confidence: High

How this decision was reached

The engine reads each signal below and applies a fixed list of rules from top to bottom. The first rule that matches sets the recommended action – like a statement, every line is shown.

SignalValue
Severity CRITICAL
CISA KEV No
Public POC Yes
EPSS 0.8%
Patch available No
Active threat No
Deciding rule
CRITICAL severity + public POC available
What every action level means
Emergency Immediate action required. Criteria: CRITICAL + in CISA KEV (actively exploited) without patch, OR CRITICAL + EPSS > 30% without patch, OR CRITICAL + active threat signals without patch.
Act Now Prioritize within 24-48h. Criteria: in KEV with patch available, OR CRITICAL + public POC, OR HIGH + EPSS > 10%, OR CRITICAL + active threat, OR any CRITICAL severity.
This Week Schedule remediation this week. Criteria: HIGH severity (CVSS 7.0-8.9). Patch within normal change window.
This Month Plan within 30 days. Criteria: MEDIUM severity (CVSS 4.0-6.9), lower exploitation probability. Include in regular patch cycle.
Monitor Track and reassess. Criteria: LOW severity (CVSS 0.1-3.9), minimal exploitation risk. No immediate action needed.

SSVC AssessmentENISA

SSVC Decision
Out-of-Cycle
Exploitation
Poc
System Exposure· derived
Open
Automatable
Yes
Human Impact
Very High
Technical Impact
Total

Priority Score

67
Low Medium High Critical
KEV: 0
EPSS: +1
CVSS: +46
PoC: +20
Weaponized: 0
Threat intel: 0
Gov advisory: 0

Attack Technique

Authentication bypass attacks exploit flaws in the verification mechanisms that control access to systems and applications.

Remote Code Execution represents the critical moment when an attacker successfully runs arbitrary code on a target system without physical access.

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