<prompt> Cart Wheel sign is seen in -ASOMAOMOMECSOM  <response>: Otoscopy Signs for ASOM:There is congestion of pars tensaLeash 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 