Had an 06 in the shop a few weeks ago that looked just like that. It looked like the #6 piston was hitting the valves, but it was actually the piston hitting the head. We thought it was a wrist pin wore out but once we tore into it, it was the rod bearing spun and the rod cap broken in half. Don't see how it was still running. A wore out wrist pin will cause this too.
To check to make sure that is what is happening, turn the engine over by hand till that piston is on TDC. Then jerk the crank shaft on over some so that the piston starts its way down. Then push down on the piston to see how much it moves. If the rod bearing is spun bad enough it will cause enough slack for the piston to jump up some and hit the head when running.