Kevin De Bruyne was key to Man City winning the Premier League last season as the Belgium international was easily the best player for the Light Blues but this season has not been too productive for him.
The midfielder has been plagued by constant injuries this campaign and he has only managed to play in 17 league games so far and most of these appearances have come off the bench.
During the past couple of weeks, Kevin De Bruyne was just about finding his feet but now the 27-year-old has been rocked by yet another injury.
The Man City man picked up a knock during the Spurs game and had to be taken off around the half-hour mark.
Kevin De Bruyne appeared to have jarred his left knee or ankle when shooting from the edge of the box and just a few moments alter the attacking midfielder was seen down on the pitch needing medical attention.
Pep Guardiola did not hesitate one moment and immediately replaced him with Fernandinho but now the real worry for the manager is whether the player will be able to feature vs Man United on Wednesday night.
Guardiola does have a number of options in midfield but if the recent games are anything to go by then surely Kevin De Bruyne would have been an automatic choice for the Manchester Derby.
If Kevin De Bruyne does miss the game during midweek then the Man City manager could opt to start with David Silva who is a similar sort of playmaker in and around the midfield area.