By Bryn Palmer

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Wilkinson (left) and Hodgson were both injured against Italy

Clive Woodward is by nature an optimist and usually has plenty of positives to accentuate.

But amid the plus points from Sunday's lacklustre victory over Italy, the England coach will be acutely aware of the precarious nature of his whole game-plan.

On one side, this Six Nations campaign has proved that the red rose contingent have strength in depth other countries can only dream of.

Which other side, with perhaps the exception of France, could accumulate a dozen injuries and still have realistic hopes of a Grand Slam?

England's casualty list L Moody (shoulder - out for season) P Vickery (back - out for season) I Balshaw (shoulder - out until mid-April) C Hodgson (knee - out for season?) J Leonard (hamstring - out of Six Nations) J White (knee - out of Six Nations N Back (calf) A Healey (achilles) B Cohen (thigh) J Robinson (knee) M Johnson (hamstring) J Wilkinson (shoulder) R Hill (groin) M Catt (hamstring)

But the three victories so far have also highlighted serious cause for World Cup concern.

Not least, how important Jonny Wilkinson's fitness has now become to England's strategy and success.

The sight of the world's best fly-half walking solemnly off the Twickenham turf on Sunday was worryingly familiar.

Wilkinson suffered more trauma to one of his vulnerable shoulders, but hopes to be fit enough to resume playing again at the weekend.

The knee injury sustained by his replacement, Charlie Hodgson, however, could seriously undermine England's hopes of negotiating a path to October's World Cup final.

If Hodgson is ruled out for any length of time, and Wilkinson's body succumbs to the heavy burden placed upon it, what are England left with?

I expect us to win our next two matches regardless of who we put out Clive Woodward

In short, a clutch of players who have either been over the course already, are past their best, or have not shown the necessary aptitude to be a top international fly-half.

Northampton's Paul Grayson has revived his career to the extent that he is next in line as England's A team fly-half.

But having won the last of his 23 caps at the last World Cup four years ago, the 31-year-old is not exactly a man for the future.

Mike Catt helped inspire some of England's best rugby under Woodward two years ago from inside centre, after some indifferent displays at fly-half earlier in his Test career.

But the injury-prone Bath pivot is still struggling to string two games together and has not played for England since the autumn of 2001.

Greenwood finished at fly-half

Wasps' Alex King is another who has endured problems with form and fitness in recent years, while the maverick Austin Healey recently announced he only wanted to be considered as a scrum-half in future.

Against Italy, Will Greenwood ended up at number 10.

No-one doubts his ability as a midfield orchestrator, but his invention and finishing prowess are required in the centre.

With Hodgson unavailable, either Grayson or Catt - hamstring permitting - are likely to be drafted into the squad for England's next match against Scotland.

And Woodward remains confident of a 21st consecutive Twickenham victory to stay on course for a possible Grand Slam decider against Ireland in Dublin on 30 March.

That said, the "get well soon" cards will once again be sent out first class this week.