England captain Michael Vaughan looks almost certain to miss the first Test on their tour of Pakistan through a knee injury with uncapped opener Alastair Cook called up as cover.

Vaughan injured his knee during this week's warmup match against Pakistan A which England lost by six wickets. He is "very doubtful" to play in the first test in Multan which starts on Saturday, team management said on Wednesday.

"Michael's orthopaedic surgeon in the United Kingdom has viewed scans of his knee taken in Pakistan and the advice we have received is that he should rest the injury," said team spokesman Andrew Walpole.

"Michael will remain with the squad and the medical team will continue to monitor his progress closely.

"He is rated very doubtful for the first Test and his availability for the second and third tests in Faisalabad and Lahore will be reassessed in due course," Walpole added.

"Michael will remain with the team and doctors will continue to monitor his progress from his knee injury closely."

Vaughan twisted his right knee while taking a third run during the three-day tour match in Lahore on Monday.

The same knee required a cartilage operation in 2002 and also kept him out of a test against New Zealand last year at Lords.

Walpole said 20-year-old Cook, who made a double century against Australia for Essex last season, would join the party later this week.

"The selectors have also decided to add (spinner) Shaun Udal and pacer Kabir Ali to the squad for the one-day series in Pakistan which starts on December 10," he said.

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