Cart Wheel sign is seen in -: (A) ASOM, (B) AOM, (C) OME, (D) CSOM
Answer is A. Otoscopy Signs for ASOM:

There is congestion of pars tensa
Leash of blood vessels appear along the handle of malleus and at the periphery giving it a cartwheel like appearance.
Transluscency is reduced.
Later tympanic membrane appears red and bulging with loss of landmarks.
Tympanic membrane is immobile n pneumatic ostoscopy