The 19-year-old had already missed Spain's 4-0 win against Georgia on November 15, and further checks from La Roja's medical team ruled him out of their final 2026 World Cup qualifier against Turkey on November 18.

Spain described the withdrawal as a precaution, a decision welcomed by Madrid. He will now return to Valdebebas for full scans to determine whether this latest issue is a fresh setback, potentially a groin-related problem, or a relapse of the soleus injury he suffered during Spain's October camp. Madrid are concerned by the timing, especially as Huijsen had faced the same problem only last month.

"Dean felt some discomfort and we did not want to take risks," a Spain staff member said. "The decision was made in agreement with Madrid for his protection."

Huijsen's troubles date back to the minor soleus tear he sustained in October, an injury suffered in training that forced him out of Spain's World Cup qualifiers. Madrid confirmed at the time that he needed a tailored recovery programme, which ruled him out of matches against Getafe and Juventus.

During his October absence, Madrid relied heavily on Eder Militao and Raul Asencio to steady the defence, and Huijsen returned just in time to feature without problems in the first El Clasico of the season on October 26.

This month's relapse is part of a wider pattern, as Madrid have seen several players return early from international duty. Kylian Mbappe and Eduardo Camavinga were both sent back by France ahead of their final World Cup qualifier against Azerbaijan on November 16.

Mbappe had scored twice in France's 4-0 win over Ukraine on November 13 to reach 400 senior career goals, but woke the following morning with inflammation in his right ankle. Although he completed the match, renewed pain prompted what the French Football Federation described as a "joint precautionary decision" with Madrid for further checks. Madrid are confident the issue is manageable but insisted on tests to avoid aggravation before a heavy run of fixtures.

Camavinga, who had not trained all week due to left-hamstring discomfort, was also deemed unfit. France had already called up Khephren Thuram as cover, and the midfielder returned to Spain with Madrid expecting him to recover in time for their La Liga trip to Elche on November 23.

Both players are projected to be available after the break, but their withdrawals underline the physical strain carried by key members of Xabi Alonso's squad.

The coming days will now revolve around clarity for Madrid. Huijsen's scans will confirm whether he faces a short rest or a recovery period similar to last month. With Mbappe and Camavinga also in treatment, Alonso may have to prepare for three possible absences as Madrid enter a demanding schedule.

Madrid face Elche on November 23, Olympiacos in the Champions League on November 26 and a meeting with Girona on November 30. Militao and Asencio are likely to be paired again if Huijsen is ruled out, while midfield rotation will depend heavily on Camavinga's readiness.

Madrid's staff expect answers within 72 hours, but one thing is already clear: the club will need careful management of their biggest names as they move into one of the busiest stretches of their season.

World Cup qualifier: Rwanda stun Bafana to go top of Group C