Rhys Ruddock's World Cup hopes were put in serious doubt yesterday when he suffered another arm injury in Emerging Ireland's 33-7 win over Uruguay.
The Leinster back-row was already in a race to prove his fitness to Joe Schmidt ahead of the tournament after an injury-hit season.
Ruddock underwent a second operation in March on an arm injury that he originally suffered against Harlequins last December which resulted in him missing the entire Six Nations campaign.
The 24-year old was substituted after just 20 minutes yesterday with an injury to the same forearm and although he left the stadium without a sling, his participation at the World Cup hinges on the results of an X-ray which was carried out last night in Georgia.
"We will have to wait 24 hours for the results of the X-ray and scan before we can make a real assessment of the injury," said Emerging Ireland head coach Allen Clarke.
"He has had a knock there before so of course I am concerned for him.
"But he is a resolute young man and I'm sure he will bounce back should this rule him out of the tournament."
Schmidt is due to arrive in Tbilisi in time for Ireland's final game against Georgia on Sunday, but Ruddock looks certain to miss out.
Meanwhile, Leinster will come up against a familiar face in Paul O'Connell after they were drawn in the same pool as Toulon for next season's Champions Cup.