"Grey's Anatomy's" Dr. Alex Karev (Justin Chambers) has always had anger issues -- from work frustration to (many) failed relationships to a naturally combative character with some serious daddy issues, he's always been capable of physical outbursts. One of the joys of "Grey's" has always been watching him transform and discover his potential, but we know his angry side is always waiting just beneath the surface.

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In this sneak peak of the Season 13 premiere, it appears the long-running ABC medical drama picks up on the same night Season 12 left off. Walking in on what looks like Dr. Andrew DeLuca (Giacomo Gianniotti) hooking up with Jo (Camilla Luddington) -- though we know he was just taking care of a belligerently drunk Jo -- Karev storms into the bedroom and beats Andrew to a pulp.

karev on feelings gif greys anatomy Greys Anatomy Season 13 premiere sneak peek: Karev headed behind bars?It's not a good look for Karev and in this clip, Karev is begging bestie Dr. Meredith Grey (Ellen Pompeo) to make sure he not only lives, but that there's no permanent physical or long-term mental damage. Even though Grey assures him the scans are clear, Karev can't seem to calm down. And for good reason!

"You talk to the police yet?" Dr. Ben Warren (Jason George) asks, while passing Karev in the hallway. Karev gives him a noncommittal, shaky yes/no answer, before Warren takes notice of Karev's bloodied knuckles. "How's the hand? It looked like it was giving you trouble earlier," he says.

alex karev on greys anatomy gif Greys Anatomy Season 13 premiere sneak peek: Karev headed behind bars?When Karev gives yet another shaky answer, "Oh, I slipped in the rain," Warren stares at Karev with deep suspicion in his eyes. "Look," he says. "DeLuca is going to clear everything up when he gets outta surgery. Is there anything ...." - and Karev cuts him off there, visibly heated by what he perceives as third degree questioning.

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"There isn't," Karev says. "I got the guy here. I helped him."

While that part is true, he's also the person who caused the injury. Karev is wracked with guilt and if he thinks that he can get away with lying to the police, he's going to find himself in even deeper trouble. While there have been numerous court cases throughout the years on "Grey's," we've never seen a lead character spend time behind bars. And that may be exactly where Karev is going once DeLuca wakes up.

"Grey's Anatomy" Season 13 premieres on Thursday, Sept. 22, at 8 p.m. ET/PT on ABC.