England star Jonny Wilkinson's World Cup campaign could be over before it has even started after his injury jinx struck again to deal the defending champions a potentially shattering blow.
Wilkinson will miss England's opening Pool A clash with the United States in Lens on Saturday due to a twisted ankle suffered in training.
The Newcastle fly-half's latest fitness blow means he is sidelined for the 34th time in 41 Tests since his drop-goal gave England World Cup glory in Sydney four years ago.
Wilkinson's immediate World Cup prospects — and whether or not he will be fit to face pivotal pool stage opponents South Africa at Stade de France on Friday week — now hinge on the outcome of a hospital scan.
England's record points scorer was hurt during a non-contact defence session less than 24 hours after arriving in France.
And while a twisted ankle might not rank on the same scale as two major knee injuries, shoulder surgery, groin trouble, a lacerated kidney and appendicitis — all among Wilkinson's fitness troubles since 2003 — England find themselves playing a depressingly familiar waiting game.
His place in the starting line-up has been taken by Bath's Olly Barkley, with big-money rugby league import Andy Farrell summoned for bench duty.
England will not issue any further medical bulletin until the scan results are known, but number eight Lawrence Dallaglio revealed Wilkinson remained "very positive".
Dallaglio said: "It looked fairly innocuous to me. I think Jonny just went over on his ankle. It is disappointing for him because he has worked incredibly hard to get fit.
"He has looked really fit and it is a disappointment for the World Cup he is not starting the competition. But I don't think we need to get it too out of perspective. He seemed to get up on his feet pretty quickly, and I think it would be wrong for any of us to speculate too much."
Wilkinson's injury overshadowed the opening England team announcement — made at a civic reception in Versailles — in which it was confirmed Wasps star Josh Lewsey would win his 50th cap.
Lewsey features in a side showing six changes from England's final tournament warm-up Test against France in Marseille just over two weeks ago. Dallaglio, veteran of 80 caps, packs down in an all-Wasps back row alongside Joe Worsley and Tom Rees.
Worsley plays at blindside flanker, while Leicester's Martin Corry, who has recovered from a knee problem, has to be content with a place on the bench.
Elsewhere, Jamie Noon and Mike Catt form the centre combination — Dan Hipkiss misses out — and fit-again Andrew Sheridan returns to the front row in place of Perry Freshwater.
England's poor lineout performance in Marseille has undoubtedly cost Bath captain Steve Borthwick an immediate World Cup start, with Leicester's Ben Kay preferred in the second row, where he will partner Simon Shaw.
Despite England's dismal run of results since they won the 2003 World Cup final - and another Wilkinson injury scare — they will be expected to start their 2007 campaign with a points blitz against vastly inferior opponents.
England (v USA): M Cueto (Sale); J
Lewsey (Wasps), J Noon (Newcastle), M Catt (London Irish), J
Robinson (unattached); O Barkley (Bath), S Perry (Bristol); A
Sheridan (Sale), M Regan (Bristol) P Vickery (Wasps, capt), S Shaw
(Wasps), B Kay (Leicester), J Worsley (Wasps), T Rees (Wasps), L
Dallaglio (Wasps).
Replacements: G Chuter (Leicester), M Stevens
(Bath), M Corry (Leicester), L
Moody (Leicester), P Richards (London Irish), A Farrell
(Saracens), M Tait
(Newcastle).
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