'Serious blow' for the English camp after Atkinson leaves the field due to a hamstring issue.
The English seamer added to the injury concerns plaguing England when he left the ground during Saturday's play of the Boxing Day Test against Australia.
The right-arm seamer pulled up with his left leg post-delivery in his spell on Saturday.
The England team stated Atkinson felt some "soreness" and was to take time off the field to undergo evaluation "over the next few hours".
The series decider of the series in Sydney gets underway this coming Sunday.
England have been without key quicks one seamer due to knee trouble and Jofra Archer with an abdominal strain during this series.
Matthew Fisher was added to the party as injury reinforcement.
The seamer had a tough time in the opening two Tests, taking just a handful of scalps.
He was dropped of the third Test, before being recalled for the Melbourne Test in the playing XI.
Surrey's Atkinson performed better in the fourth Test, bagging two scalps during the host's first knock, and scoring 28 runs with the bat as one of just three England players who passed ten runs.
Following a brief spell at the end of day one, he came back the next day and had nightwatchman Scott Boland caught behind.
Yet, at the end of his spell, he delivered a change of pace to Travis Head and suddenly grabbed for his hamstring.
The English bowler was recalled for the fourth Ashes Test having missed of the third.