Borussia Dortmund captain Marco Reus is again in danger of missing a major tournament for Germany.
The 33-year-old Reus was stretchered off in the first half of Dortmund's Ruhr derby against Schalke on Saturday with what looked like a serious ankle injury.
Reus was in tears after bending his right ankle unnaturally in a challenge for the ball with Schalke's Florian Flick. American Gio Reyna came on for Reus while Flick was able to continue after treatment on his knee.
Flick's namesake Hansi Flick - the Germany coach - had included Reus in his squad for the upcoming international games against Hungary and England and was counting on the attacking midfielder as a key member of his World Cup squad.
The tournament starts in Qatar on November 20. Germany plays Japan in Doha three days later, four days before it faces Spain in Al Khor, where it also plays its last game in Group E against Costa Rica on December 1.
Reus has been plagued by injuries at inopportune times throughout his career. He missed Germany's World Cup win in 2014 with an ankle injury sustained in a warm-up game, and a groin injury ruled him out of the 2016 European Championship. He played in Germany's unsuccessful World Cup defence in 2018 but skipped the next European Championship to recover after his season with Dortmund.
There was no immediate word from Dortmund on the seriousness of Reus' injury. The player was still receiving treatment in the changing room before halftime and was due to be brought to a hospital.
Reus has 15 goals in 48 games for Germany.