Luther Burrell became the latest England centre to suffer a setback ahead of next month's internationals when he sustained a hand injury during Northampton's European Rugby Champions Cup win over the Ospreys on Saturday.
Burrell left the field clutching his right hand at English champions Northampton's Franklin's Gardens ground in the 43rd minute of the Midlands club's 34-6 pool defeat of Welsh regional side Ospreys.
Fellow centre Manu Tuilagi has already been ruled out of England's end-of-year Twickenham opener against world champions New Zealand on November 8 because of a groin problem.
Burrell's involvement in that match, as well as next month's subsequent Tests at 'headquarters' against South Africa, Samoa and Australia, has also been called into question
"Luther has banged his hand. It's very sore and he's struggling to grip. He'll have to go for an X-ray on that," Northampton director of rugby Jim Mallinder said.
"He gave it a chance and put some tape on at halftime. Fingers crossed there's no permanent damage.
"It could be anything -- it was a bone in his hand."
England's rugby league convert Sam Burgess, who is tipped to play at inside centre, is expected to be sidelined until the new year after fracturing his cheekbone in the NRL grand final earlier this month.
England coach Stuart Lancaster has the option of adding to his original 33-man squad by calling up additional players on Sunday.
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