The all-rounder, who has played 47 Tests and 175 ODIs, flew down here today for a fresh MRI scan of his knee and the results were not positive at all for him.
A source in the Board said the MRI scans had shown that the condition of his knee has not improved although he has been getting treatment for it since April at the National Cricket Academy in Lahore.
Hafeez, who already had to miss a three week long boot camp in Kakul and is also out of the skills camp underway in Lahore, contacted a Pakistan-born doctor Zafar Iqbal who has worked in the UK.
The doctor, who also works with the Crystal Palace football club, advised Hafeez to first get a fresh MRI at a private hospital.
The source said the PCB had yet to find a proper replacement for the long serving medical manager Dr Sohail Saleem who had resigned after the World T20.
Hafeez has been named in a shortlist of 21 probables by the national selection committee for the England tour but subject to his fitness.
The source said surgery on his knee has not been ruled out which could mean Hafeez missing the entire series in England.
"I want to play cricket as soon as possible. This injury has not disheartened me," Hafeez said.
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