Jarell Quansah was subbed off against Panama due to injury on Saturday as England suffered yet another blow at right-back.
Thomas Tuchel's men played out their final group game at the New York New Jersey Stadium, with Jude Bellingham giving his team a 1-0 lead just after the hour mark.
However, the Three Lions were forced to bring Jarell Quansah off moments prior to their opener after the defender went down holding his ankle.
The centre-back started the game as England's right-back, with Tuchel opting to deploy the 23-year-old in that position in light of Reece James's injury.
Djed Spence was brought on in place of Quansah, and he is currently the team's only fit right-back in a major concern ahead of the round of 32.
How long do ankle injuries take to heal?
Ankle injuries can in the worst case scenarios leave players sidelined for months, with a grade three injury needing a carefully structured rehabilitation programme.
Quansah would certainly be ruled out of the rest of the World Cup given the tournament's final is set to take place on July 19.
Even a milder issue - grade two - would require at least three to six weeks on the treatment table, and that would likely prevent the defender from playing again this summer.
If Quansah has been fortunate and suffered a grade one injury, then he may be back within a week, though it is not uncommon for players to miss two weeks of action.
Reece James and Jarell Quansah injuries: Trent Alexander-Arnold mistake?
Spence is an incredible athlete and can be valuable, but he is somewhat limited with the ball, meaning England's right flank could be blunt in the latter stages of the tournament.
James is expected to be fit before the end of the World Cup, but the Three Lions may still have to navigate multiple knockout rounds before the Chelsea star is ready to play.
The decision to leave out the likes of Trent Alexander-Arnold looks like it could backfire on Tuchel, who opted to take a defensive-oriented squad with him to North America.
If England suffer an early exit, the head coach will be under serious pressure to explain his selection choices, and some fans may even question his future as manager.