Ross Stewart lay in a crumpled heap at Craven Cottage, banging his fist against the turf in pain. A couple of minutes later, Sunderland's talismanic striker departed on a stretcher with a serious Achilles injury - a problem that could, if it is as bad as boss Tony Mowbray fears, end his season - and returned to Wearside wearing a protective plastic boot.
It was the nightmare scenario for Sunderland: losing their star man in an FA Cup tie with all the potential repercussions it could have on the Championship campaign that remains their top priority. With Ellis Simms having been recalled by Everton from his loan stay on Wearside at the beginning of the month, Mowbray was asked this week whether he was frustrated at the delay in bringing in another striker as it had left him with no option but to risk Stewart, the club's only out-and-out striker, in the cup.
As it was, Sunderland signed Joe Gelhardt on loan from Leeds United on Friday as competition and cover. But Gelhardt was cup-tied and could not play in the fourth round game at Fulham, leaving Mowbray with Hobson's choice as Stewart played and ultimately suffered his second major injury of the season.
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Back in September, Stewart pulled out of the warm-up at Middlesbrough with a thigh injury which sidelined him for three-and-a-half months. Just six weeks - and six goals - later, he is sidelined again and this time it could be significantly worse.
The only consolation for Sunderland is that, unlike when Stewart picked up his injury in September, at least this time the transfer window is still open which means they can bring in another striker to support Gelhardt. When Stewart suffered that injury earlier in the season, the window had shut just four days before and it meant that Simms was left as Sunderland's sole fit frontman - and, wouldn't you know it, just ten days later Simms also picked up an injury leaving the Black Cats to battle on without any strikers at all for six weeks.
Sunderland will now go back to the Merseysiders and explore the possibility of bringing Simms back to Wearside for the rest of the season and that, in the current circumstances, would be the ideal solution. Nonethless, Stewart's absence will still be keenly felt - and all the more so given that his injury came in the same week that influential skipper Corry Evans was ruled out for the remainder of the season with a ruptured cruciate ligament.
Despite being missing from the end of August until mid-December, Stewart has scored ten Championship goals in 13 appearances this season. With Sunderland currently sitting just a point outside the play-off places, it is only natural to wonder where they might be had Stewart been fit all season.
And it's a question that could well be asked again in May. Stewart's injury overshadowed what was a fine performance from the Black Cats against Premier League opponents in the cup, as they secured a replay back at the Stadium of Light.
Mowbray said beforehand it was an opportunity for Sunderland, a side that had finished fifth in League One last season before securing promotion via the play-offs, to test themselves against a side that finished top of the pile in the Championship last term and currently sits seventh in the Premier League and is in with a chance of of European qualification. And the game was a wonderful advertisement for the FA Cup - an open and pulsating encounter with multiple chances at both ends.
Jack Clarke's early goal gave the 6,000 travelling fans something to shout about, and Sunderland could have extended their lead with Amad, Patrick Roberts, and sub Abdoullah Ba among those missing opportunities. Fulham also had chances, and in the first half it took an incredible goalline block from Dan Ballard to deny Andreas Pereira.
Eventually, Tom Cairney levelled on the hour, and then man of the match Anthony Patterson produced a string of saves to keep Sunderland in the competition. Mowbray handed a senior debut to new signing from West Ham Pierre Ekwah, with the 21-year-old acquitting himself well in midfield when he came off the bench in the final quarter-hour.
Fellow sub Chris Rigg thought he had made headlines near the end when the 15-year-old fired in off the underside of the bar in front of the away end, but his celebrations were cut short by an offside flag raised against Ba in the build-up. If the replay is half as entertaining as this breathless initial meeting, it will be some game.
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- Sunderland earn an FA Cup replay against Fulham but Ross Stewart injury casts a shadow over the tie