A teenager with a pimple in the palm of his hand. There was a pencil injury in unknown circumstances somewhere in Europe, doctors in Europe doing something (no papers was provided). He was sent for an ultrasound with a suspected fistula and a request to search for a pencil lead. At ultrasound pencil lead was not found. There is a hook-shaped canal (fistula tract) extending distally into the intermetacarpal space with inflammation of the surrounding tissues.
