Byron Leftwich, the second-string quarterback, is warming up on the sideline.
Roethlisberger hasn't been injured this season, but hurt his ankle in the middle of the Steelers' Week 15 game last year at San Francisco. He returned to the game, but the Steelers lost 20-3.
They're tied with Kansas City in a game where the Steelers' run defense is sagging. That may get worse, as cornerback Ike Taylor was laying on the ground on the drive after Roethlisberger was hurt.
The Chiefs are playing tough in the trenches, but neither team looks particularly sharp. The conditions aren't ideal for passing, and neither quarterback looks good at all.
In a sloppy game, running and turnovers may determine it. Or, missed field goals, which Chiefs kicker Ryan Succop just missed from close distance.