England head coach Steve Borthwick has reportedly decided to go with George Ford at fly-half against Italy over Fin Smith after Marcus Smith suffered an injury setback.
England have been preparing for the start of the Six Nations at their training camp in Girona and Borthwich was dealt a huge blow on Monday when it was revealed the 24-year-old had picked up an issue.
They're looking to get a second opinion on the injury, but there are fears Smith could miss multiple Six Nations games.
With Owen Farrell stepping down from England duty at the end of last year, Smith was seen as the frontrunner to become the nation's new starting fly-half.
But his injury made it a straight fight between Ford and Smith, a 21-year-old rookie who has earned huge praise for his performances with Northampton.
George Ford is set to start as England number 10
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According to the Telegraph, the experienced Ford has been selected over Smith to start as England's number 10 against the Azzurri.
Ford steered England to a stunning victory over Argentina at last year's World Cup with a heroic display with the boot, but he ended up being dropped for the knockout stages as Farrell resumed his role as the first-choice fly-half.
But it's elsewhere in Borthwick's line-up that may raise some eyebrows.
The uncapped duo of Ethan Roots and Fraser Dingwall are reportedly set to be handed their international debuts.
The Exeter flanker is said to be in the side to start as blindside flanker alongside Sam Underhill and Ben Earl.
Meanwhile, Dingwall will partner Henry Slade in the midfield at inside centre.
Freddie Steward will reportedly get the nod at full-back while Elliot Daly and Tommy Freeman will provide the speed on the wings.
Ford is set to be partnered by England veteran Danny Care as the number nine with Alex Mitchell reportedly suffering from an 'infected wound in his leg' that has prevented him from training.
Care and Ford will give Borthwick vasts amount of experience on the field with the pair combining for 187 caps between them.
Jamie George will step onto the field as England's captain for the first time in the front row alongside Will Stuart.
Maro Itoje, Ollie Chessum and Joe Marler reportedly complete the tight five with Borthwick going strong for England's Six Nations opener.
But the England head coach has been limited in some of his selections for this year's Six Nations with a host of players moving to leagues abroad, making them ineligible for selection.
Marcus Smith has been ruled out through injury
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Henry Arundell is one of England's brightest young talents, but he moved from Racing 92 from London Irish to make unable to represent his country for the time being.
The RFU's current selection criteria bans players who play outside of England from being selected for the Test side.
Borthwick spoke last year of his hope that the RFU would eventually abandon the selection criteria on players playing overseas.
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Danny Care is one of England's most capped players
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“What we are faced with here are some extreme circumstances,” said Borthwick.
“There are discussions ongoing about what this means and what the implications are going forward.
"It’s about the players’ livelihoods and careers as well. From my point of view I want to make sure we are able to select the greatest number of players possible. And the best players possible."
He added: “Nobody should have to go through the level of uncertainty they have had. Nobody should. With that in mind, I think this game is exactly what we need. We want these big exciting games that are full of passion that allow us to concentrate on the rugby."