From the case:
Incudomalleolar dysarticulation
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The head of malleus in the attic on the right is seen in isolation; the incus in not present (on a lower slice, not shown). This is in keeping with disarticulation of the incudomalleolar joint.
Case Discussion
The articulation of the incus and malleus should appear as an ice-cream ball on an ice-cream cone on axial images and should be check area on all scans through the region, especially if head trauma and base of skull fractures are present.