South Africa's Dale Steyn bats in first Test against England

Steyn left the pitch mid-over twice on day three due to a spasm in his right shoulder, though scans showed no sign of a muscle tear.

He underwent a morning fitness test at Kingsmead in an attempt to help the Proteas claw their way back into a game that was rapidly slipping away, but again felt discomfort and did not take to the field.

With South Africa facing a stern challenge to save the series opener, Steyn came in as nightwatchman after the late departure of Faf du Plessis.

But with just two days between the fifth day in Durban and the start of the Cape Town Test on January 2, Steyn is also a major doubt for that game.

South Africa team manager Dr Mohammed Moosajee, who accompanied Steyn to hospital on Monday, told Test Match Special that the 32-year-old was "touch and go" for the second game.

Kagiso Rabada is already in the Proteas squad as the spare seamer, but an SOS may now be issued to Marchant De Lange, who is next in line.

Steyn was an injury doubt for the first Test having spent seven weeks on the sidelines with a groin strain and, although he passed a rigorous fitness test before Christmas, South Africa believe the lay-off may have been a contributing factor to his current problems.

As England target what would represent a superb first-Test victory at Kingsmead, everything seems to be going Alastair Cook's side's way with the unfortunate injury to Steyn. Arguably the world's best bowler, the paceman is South Africa's talisman and his fitness has to now be in question for the remainder of the series. Fortunately the early scans have not flagged up a muscle tear, but strains and spasms in the shoulder area can prove highly problematic for fast bowlers. With a healthy lead already on the board, England have to now be firm favourites to claim victory in the series opener.