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 The Cavs said X-rays were negative, adding he would be evaluated again Thursday.
James returned to Cleveland's bench late in the third quarter, sporting a suit and turtleneck, with tape wrapped around his index and middle fingers on his non-shooting hand. Late in the half, ice was packed and wrapped briefly over his left hand.
He appeared to be injured with 4:41 left in the first half, when Detroit center Nazr Mohammed fouled him. James made both free throws and stayed in the game.
James had 15 points and three assists in the first half, accounting for more than one-third of the Cavs' points, in a rematch of the Eastern Conference finals.
He had been sensational recently, including Tuesday night in an overtime win over Boston, and entered the game averaging 31.7 points, 8.5 assists and eight rebounds a game this season.
Detroit's Richard Hamilton scored 18 points, Tayshaun Prince had 16 and Antonio McDyess added 14 in a game the home team led 48-43 at halftime against James.
When the star was stuck on sidelines for the second half, the Cavs had no shot to come back.
The last time James was in suburban Detroit, he turned in one of the best playoff performances in NBA history.
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He scored 48 points, including the final 25 for his team, to lift the Cavs to a win in Game 5 of the conference finals, and helped them win the next game at home to reach the NBA finals for the first time in franchise history.
Sasha Pavlovic scored 13 points and was the only Cleveland player other than James in double figures. Drew Gooden had nine points and nine rebounds.
The Cavs, who played their fourth game in five days, were to travel to Toronto to face the Raptors on Friday night.
Rasheed Wallace returned to Detroit's lineup after a sore knee kept him out for two-plus games. He had nine points, eight rebounds and three assists.
The Pistons were able to rest their regulars after outscoring Cleveland 29-16 in the third quarter, turning a close game into a rout.
Notes: Detroit rookie Rodney Stuckey (left hand surgery) was evaluated Wednesday, and still isn't cleared for contact in workouts. ... Cleveland was assessed with a technical in the fourth quarter for using a full timeout, instead of a 20-second one, late in the third.
[Associated Press]
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